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Rhinoplasty - an Atlas of Surgical Techniques Edited by Rollin K. Daniel Springer-Verlag, USA, 2002 ISBN 0387944583, £202.50
The author of this lavishly illustrated textbook states that his aim is to describe the analytical and technical aspects of rhinoplasty that he would teach a Rhinoplasty Fellow during a six month attachment. He provides an explanation of his thought processes in planning surgery and the surgical principles that he uses in rhinoplasty. Perhaps because of this the layout of the text and the accompanying DVD deviates from the standard format of most such textbooks and manuals. The first chapter, for example, deals with the nasal radix, an area often neglected in pre-operative planning and intra-operatively. The author goes on to describe surgical techniques appropriate for surgery of the nasal dorsum, nasal tip and nasal base. While this is satisfactory for the experienced surgeon, the beginner would be at risk of losing sight of the wood for the trees. The DVD is designed to be used in conjunction with the text and greatly enhances the descriptions of surgical techniques. This is not a textbook for the inexperienced rhinoplastic surgeon. The author is eclectic in his choice of, and indications for, the use of various surgical techniques. The illustrations are of a uniformly high quality. Operative techniques are illustrated using diagrams, photographs of cadaver dissections and intra-operative photographs. They are appropriately placed in the text.
This book is written by a plastic surgeon who recognises the importance of maintenance and provision of adequate nasal airways in cosmetic nasal surgery. He emphasises the importance of good pre-operative assessment of the airway and discusses ways of avoiding post-operative nasal obstruction in a satisfactory if somewhat idiosyncratic manner.
Due emphasis is placed on current concepts of grafting techniques. Open structure rhinoplasty is discussed and illustrated extensively. While one would disagree with some points of technical detail even the most experienced rhinoplastic surgeon will find nuances of technique to enhance his practice. The chapter on secondary rhinoplasty is particularly useful in this regard.
This is a textbook for the experienced rhinoplastic surgeon wishing to review and refine his techniques. It represents the considerable experience of one surgeon who freely admits that the writing of this textbook has clarified his own thoughts, expanded his knowledge and made him a better surgeon. I have little doubt that this book and DVD will do the same for other surgeons and can be recommended to those with experience in this type of surgery and also for the libraries of institutions and practices where such work is regularly undertaken.
Mr R.L. Blair
Ninewells Hospital & Medical School, Dundee
Hormone Therapy in Breast and Prostate Cancer Edited by V Craig Jordan and Barrington J A Furr Humana Press Inc., New Jersey, 2002 ISBN 0896036731, £102.00
This volume on ‘Hormone Therapy in Breast and Prostate Cancer’ is the latest in a series on Cancer Drug Discovery and Development. It is, therefore, not surprising that the emphasis tends towards drug development rather than clinical management of these common cancers (not that management is neglected with chapters dedicated to tamoxifen, aromatase inhibitors and LH-RH agonists and the treatment of breast cancer and anti-androgens and LH-RH agonists and therapy for prostate cancer). More basic contributions focus on antioestrogens and the cell cycle, drug resistance to antioestrogens, mechanisms of liver carcinogenesis and the molecular actions of androgens and anti-androgens.
In reviewing this book, there are two issues which need to be addressed: (i) why hormone therapy in breast and prostate cancer and (ii) why should this interest members of the surgical fraternity. With regard to the former, the message is simple-hormone therapy in these two most common solid malignancies is a success story and a triumph for rational drug development. This volume tells the tale of how specific and potent drugs have evolved through painstaking research to replace surgical ablation of endocrine organs, procedures which were irreversible and fraught with morbidity. To paraphrase the rhyme given by Elwood Jensen in his foreword:
“A lady with growth neoplastic
Thought ‘surgical’ ablation was just a bit drastic.
She preferred that her ill
Could be cured with a pill,
Which today is no longer fantastic.”
So why should this interest surgeons beyond those with an oncological interest? Optimal management of both breast and prostate cancer is multi-disciplinary and it is important to know the strengths and limitations of each discipline. Chapters in this volume define these parameters succinctly. It is also true that other chapters provide a degree of experimental detail and technical jargon which might be off-putting to a non-specialist. Such variation in format and detail is a common weakness in multi-author compendiums. Another potential limitation is that this is a rapidly developing field and the time taken to assemble the contributions inevitably mean that events have overtaken some observations. Presumably to counteract this, the editors who are leading experts in the area (and have been personally responsible for some of the seminal findings) have added a final chapter on recent progress. This concentrates on breast cancer, a reflection of the greater momentum in this solid tumour.
In summary, this volume is a most useful reference text which reviews the history of endocrine therapy, laboratory discovery and clinical practice of breast and prostate cancer.
Professor W.R. Miller
Western General Hospital, Edinburgh
Oxford Textbook of Orthopedics and Trauma Volume 2 Edited by C Bulstrode, J Buckwalter, A Carr, L Marsh, J Fairbank, J Wilson-MacDonald and G Bowden; Oxford University Press USA ISBN 019262681 7 £350.00 Volumes 1- 3
This is a multi-author, multi-national textbook attempting to draw together the threads of a complex and wide ranging subject. In their preface the editors point out that there is a remarkably variable approach to orthopaedic management throughout the world which does not quite make sense, although clearly the reasons are in part obvious and in part not, namely, there is a great range of opinion and, as yet, not truly formed consensus that is highly influenced by cultural and attitudinal differences, so inevitably orthopaedics is diverse. They point out that there has been a shying away from comprehensive textbooks and there may well be a good reason for this in that it is extremely difficult to write such a book. Their aim is to produce a well referenced text that they describe as needing to be thumbed to settle doubts. I don’t think they have achieved that, but I think they have made a worthy effort to produce a book that would act as a handy source book for people studying for Board and Intercollegiate examinations, which I suspect is a major agenda in the book. They have tried to confine the whole subject into a relatively small space and this inevitably leads to compromises. It inevitably becomes a bit of a skim and perhaps then the references become important.
One inevitably turns to sections one knows about when one checks the references and I would have to say in the sections where I have my own personal interest I was a bit disappointed. For a textbook that is long in gestation it is inevitable that the references feel dated. Apart from that it is a useful summary and I think someone on a six year programme would find the book a good basis for a study guide. It is a worthy effort and I think it might gain popularity among trainees. The big let down of the book is the quality of the illustrations, this is in part due to the paper it is printed on and it tends to add to the slightly dated feel of the book. For example, histological pictures in black and white seem pretty pointless and the absence of colour is a major drawback.
I support the final conclusion that a book like this is inevitable a curate’s egg and there are certainly bits of it that are attractive but none of it that couldn’t be found by careful use of the literature. What we are still lacking is not so much a comprehensive textbook as a comprehensive study guide which is far from the same thing.
I think the book will appeal to a wide audience, particularly those who want to just go a little bit beyond what they find in undergraduate textbooks, but I suspect forming a comprehensive text that could solely and entirely be used for the exam I might be a little more sceptical.
Professor D.I. Rowley
Ninewells Hospital and Medical School, Dundee
Oxford Textbook of Orthopedics and Trauma Volume 3 Edited by C Bulstrode, J Buckwalter, A Carr, L Marsh, J Fairbank, J Wilson-MacDonald, G Bowden Oxford University Press USA ISBN 0192626817 £158.00 £350.00 Volumes 1-3
This is the third of three volumes concerning orthopaedics and trauma. Overall the editors are to be congratulated in completing what must have been a very difficult task. There are a hundred chapters in the volume concerning both adult and paediatric orthopaedic trauma and paediatric orthopaedics. The complexity of editing such a volume is seen in the inevitable variation between chapters. It is clear that a significant number of the chapters were actually completed some years ago and have not been updated. This is regrettable as inevitably they do not contain all appropriate current references. One would expect some variation in quality between the chapters and indeed this is the case. Overall the standard of chapters is very high and I believe that the authors have succeeded in their goal of creating a book which provides an easily accessible yet comprehensive source of information.
The book has been well edited and the presentation is excellent. The illustrations and diagrams are of very high quality the use of boxes with bullet points to illustrate the essentials of orthopaedic management is to be recommended.
Clearly the book is not as comprehensive as the major trauma texts but that is no bad thing. It is easy to read and I think surgeons will find it helpful. I would certainly recommend it to both consultant surgeons and surgeons in training.
Mr C.M. Court-Brown
Royal Infirmary, Edinburgh
Shackelford’s Surgery of the Alimentary Tract Fifth Edition Volume I Edited by Mark B Orringer and Richard Heitmiller WB Saunders Company USA ISBN 072168204 £140.00 (Set of 5 £355.00)
Volume I of Shackelford’s Surgery of the Alimentary Tract - Fifth Edition contains 551 pages of high quality paper and costs £140. It is a multi-authored presentation representing a revision of the Fourth Edition, which was published in 1996.
In the preface to the Fifth Edition, it is suggested that the Fourth Edition was a classic reference text. It also suggests that the Fifth Edition’s publication was prompted by dramatic changes in surgical practice and operative approaches as well as non-invasive therapies that have occurred in the past few years.
It is profoundly disappointing, therefore, that such a new edition devoted to recent advances should look so dated in its format. Upon opening the book, one is immediately struck by the archaic layout and the monotonous uniformity of the typeface.
Surgeons, by the practical nature of their occupation, tend to be attracted to books that are well illustrated. If there was one major failing with this book, it is the ratio of the printed word to the adequate illustration. Everything is black and white. The monochromatic monotony does not invite the reader to delve deeply. Much is made of radiological studies and many of the radiological reproductions are extremely poor. Furthermore, the vast majority of the illustrations are so poorly reproduced as to be meaningless and I gain little from monochrome, unlabelled pictures of pathological specimens. Similarly, in this day and age, monochrome histological slides are totally unwarranted in a textbook of this nature. The illustrations appear to have been very poorly scanned into the text and many of them are out of focus and indistinct.
Whilst I would not deny that for the highly motivated, the relevant information concerning oesophageal anatomy, physiology, surgery and pathology can be gleaned from this text, the whole format of this book does not invite the reader to share in its abundant knowledge. It is not a book that I would look forward to revisiting and is a new edition only by virtue of its new additions.
Mr T.J. Crofts
Royal Infirmary, Edinburgh
Essential Surgical Practice - Higher Surgical Training in General Surgery - Fourth Edition Edited by Sir Alfred Cuschieri, Robert J C Steele, Abdool Rahim Moossa Oxford University Press, NY ISBN 034080638, £125.00
This is a colossus of a book. The Fourth Edition has been published in two parts-one for basic surgical trainees that was out last year and now the volume for Higher Surgical Trainees (HST). This departure from the previous editions is rightly regarded by the authors as “a milestone in the history of this book” whose previous editions have served surgical postgraduates very well. Professor Steele has very ably stepped into the shoes of one of the previous editors, the late Professor Giles.
This is a different book, not just a new edition. The layout is completely new. As you read through a chapter (referred to as module) there are bullet points summarising the important aspects; if there are several bullet points, they are enumerated in a table. This helps to see the wood for the trees. Algorithms abound-thus helping systematic understanding of the subject. There are extensive references with good cross-referencing.
The clearly labelled line drawings are excellent, the photographs are clear and the addition of colour pictures (not in previous editions) enriches the book immensely. These factors along with the high quality of the print makes this edition stand out from its predecessor-a reflection on the new publishers perhaps. With detailed anatomy pictures, reproductions of various imaging modalities and clinical photographs, the HSTs aspiring to do the Exit FRCS need look no further for a comprehensive knowledge and understanding of general surgery.
The book is in 9 sections with each having several modules except 7, 8, and 9, which have one module each-on neonatal surgery, transplantation and plastic surgery, topics of passing interest; nevertheless they have enough detail. All modules at the start have a synopsis of the contents whilst some of them also have an introductory summary. The net has been cast far and wide for authors. The first section starts with a module on trauma written by a big team (almost a committee!) and has everything that a general surgeon should know and might have to deal with prior to seeking specialist opinion.
All the general surgery modules including those on endocrines are detailed enough for the HST declaring this subject as a special interest for the FRCS (Gen). It is refreshing to see a note on history in the introduction of the adrenal gland module. The modules dealing with the entire gastrointestinal tract and hepato-biliary and pancreatic surgery have every aspect of importance to the surgeon and, in keeping with other parts of the book, is very well illustrated.
The second section deals with vascular surgery with more modules than the first on general surgery. Second only to general surgery in its exhaustiveness, it is equal to it in its punctilious presentation-not surprising, considering the authorship includes names that would fit into a Who’s Who in British vascular surgery. I learnt a lot from the module on vascular physiology. Once again, 5th/6th year SpRs preparing for FRCS (Gen) with special interest in vascular surgery will find everything that is necessary to prepare for the examination. Appropriately, the authors say in their preface that “this book is addressed to higher surgical trainees and young consultants in general surgery and in vascular surgery”.
The sections on neurosurgery, head and neck and thoracic surgery contain a lot more than is necessary for most HSTs, in general surgery. Modules on head and maxillo-facial injuries and the applied anatomy and physiology of the respiratory system are a mandatory read. The section on urology is very comprehensive. The senior HST with a special interest in colorectal surgery should have no excuse for not knowing where the prostate gland is! Dare I say the HST for FRCS (Urol) could use this section as a revision.
This is a complete book for the HST doing the FRCS (Gen), irrespective of the candidate’s declared interest. The tome is miles ahead of its competitors. Courtesy prevents me from naming them which also find a place on my table. Although this is a review of the 2nd volume, to get maximum benefit, one should have both volumes. The HST will find that the books are worth their weight in gold and no one going to the FRCS (Gen) should be without them. After all, the combined cost of both volumes is less than one-third of the examination fees.
Having said that, as one originally from the Indian subcontinent, can I make a suggestion (even a plea) to the publishers: This is such a monumental work that it should enjoy truly international readership. Sadly surgical trainees from developing countries will never be able to buy it; and there is a massive readership out there. The cost of the book would equate to 2 to 3 months of their salary. Knowledge, like health, should not be the prerogative of only those who can afford it. An international soft-back edition, specifically for developing countries, should be made available at a realistic price, only to be sold outside the UK and USA (one of the rivals of this book has such an edition). Altruism towards the less fortunate would not go amiss. Only then the scourge of publishers - pirate copies-can be eliminated or at least minimised.
Mr P.K. Datta
Caithness General Hospital
Surgery of the Alimentary Tract, 5th Edition, Volume III Edited by Jeremiah G Turcotte WB Saunders Company USA ISBN 0721682065
Volume III of this five volume set represents the first revision since 1996 of this book which has its origins at the Johns Hopkins University School of Medicine. Furthermore, new chapters have been added to reflect the move towards minimal access treatment of hepatobiliary and pancreatic disease. It is nonetheless disappointing that the editors have been unable to identify any contributor outside North America. There is no indication as to the intended target readership but the format and content would suggest that it is aimed at training and practising surgeons with a specific interest in hepatobiliary and pancreatic surgery.
All the major disease processes which relate to surgical practice in this area are covered. All but six of the 39 chapters are multi-authored and this may account for the often varied lay-out of many of the chapters. The obvious strength of the book is the section dealing with the pancreas which is well referenced and up to date.
The section on the biliary tract includes a new chapter on laparoscopic cholecystectomy but it would have been preferable to have seen a contribution integrating both traditional and newer techniques in the management of gall stone disease. Considerable detail is provided on a variety of surgical approaches for any given condition. This is exemplified in the chapter on the management of benign biliary strictures where the reader is left wondering precisely in what circumstances a modern biliary surgeon might employ the procedure of choledochoduodenostomy as opposed to hepaticojejunostomy Roux-en-Y.
The section on Liver has maintained a traditional approach with detailed description of the surgical treatment of conditions, the management of which have largely passed into the hands of the physician. The chapter on portasystemic shunting, for example, describes a variety of surgical approaches to the management of portal hypertension and yet much of the cited evidence dates from publications in the1970s and 1980s. The detailed chapters on the management of splenic disease in adults and children are welcome since this is an area often neglected in specialist texts.
The reproduction of many of the radiographs and illustrations is of variable quality and a substantial number of the illustrations are referenced from other texts which rather leaves the reader with the impression that their financial investment might be better placed elsewhere. This volume may struggle to better the competition that already exists in this specialist area.
Professor O.J. Garden
The Royal Infirmary, Edinburgh
ABC of the Upper Gastrointestinal Tract Edited by RPH Logan, A Harris, JJ Misiewicz and JH Baron BMJ Books ISBN 0727912666 £14.95 £140.00
I have always thought that this series of books, a compilation of articles from the BMJ, represent good value for money and should be present on most practitioners’ bookshelves. This addition to the series is no exception. It is coherent in style given the multiplicity of authors and provides a remarkable breadth and depth of current information within its 48 pages.
The aim of this book is to provide any practitioner with a safe and logical approach to identify patients with upper gastrointestinal symptoms who need treatment or specialist referral. It is entirely appropriate that the book opens with an analysis of the implications of dyspepsia for the NHS since the problem is vast. Almost half the population will experience dyspeptic symptoms in a one year period.
Subsequent chapters cover the aetiology and management of heartburn, dysphagia, ulcer disease, upper gastrointestinal cancer and gall bladder disease. There are good chapters on functional dyspepsia and abdominal pain. Helicobacter features large but I think one chapter would have been enough, rather than two.
Nine clinical treatment algorithms feature throughout the book. These adopt mainly a symptom-based approach to problems as diverse as oesophageal pain and dysphagia to the gastrointestinal side-effects of NSAID’s. I thought that these were useful in summarising and enhancing the main body of the text. Colour illustrations are used liberally throughout the book although I am not sure all the photographs are informative. Do we really need to see two (artificially coloured) electron micrographs of the helicobacter pylori organism? Is the helicobacter genome display essential here? Some of the X-ray reproductions could be clearer if labelled. The description of the mechanism of the urease test for helicobacter is imprecise.
The references and suggestions for further reading are patchy and an opportunity to provide a focussed bibliography has been missed here. These are minor criticisms in a book which offers much to its broad target audience. I have ordered my copy.
Mr R. McIntyre
Dr Gray’s Hospital, Elgin
TxNxM1:The Anatomy and Clinics of Metastatic Cancer J M Debois Kluwer Academic Publishers ISBN 0792367936 £158.00
This is an encyclopaedic review of metastatic disease bringing together information on the incidence, symptoms, pathology, diagnosis and imaging of metastases in all parts of the body and from a large number of primaries. Aspects of treatment are not discussed.
The author has spent a lifetime in the treatment of malignancies and this work is the result of his extensive experience in this field. The book is divided into two main parts: the first part looks at a wide range of anatomical sites in which metastatic disease may be found and reviews the various malignancies that have been reported to metastasise to these sites. The second part of the book looks at the problem from the other direction, reviewing primary malignancies and discussing the sites to which they have been reported to metastasise. The range covered is enormous: for the sites of metastatic disease, not only are the common areas such as lung and liver extensively discussed but also much rarer sites such as the submandibular salivary glands and the foetus (13 cases from melanoma and lymphoma). Similarly, the primary malignancies discussed are equally wide ranging, including not only common malignancies such as carcinoma of the bronchus, breast and colon, but also rarer tumours such as those arising in the eye, pituitary gland and sarcomas of the pulmonary artery. The definition of a metastasis is fairly wide and includes direct invasion of adjacent organs from a contiguous primary lesion which some might not accept as a true metastatic disease.
The information in this book is based on long clinical experience in the management of malignant disease and also the review of some 12,000 references in the authors database. The reviewer is uncertain as to the value of the “bibliometry” sections in several chapters where the author contends that the number of references/articles on metastases in a given area should more or less reflect the incidence of metastases at that site. However, much of the remaining data provided by this book will be invaluable to those who wish to review malignant disease and its metastatic spread.
The author is Belgian and it is apparent in some areas that the book has been translated into English, as one or two inconsistencies are seen. It is perhaps unfortunate that the fourth word of the introduction is misspelt and was missed by the proof readers. This book will be of value to those learning about malignant disease and wanting to gain insight into the patterns of spread of primary malignancies. In addition, the first part of the book is useful in reviewing the likely origins of metastatic disease in the various sites. It provides a wealth of information and references on the subject of metastatic disease and would be a useful addition to the library of any department dealing with the diagnosis, investigation and treatment of malignant disease.
Mr P. Allan
Royal Infirmary, Edinburgh
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