For more than 80 years, Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice has been the go-to text for trainees and surgeons at all levels of experience for definitive guidance on every aspect of general surgery. As the oldest continuously published textbook of surgery in North America, this fully revised 21st Edition continues to provide the key information, essential teaching pearls, and completely updated content needed to make the most informed surgical decisions and achieve optimal outcomes for patients. Concisely written and evidence based throughout, it covers the breadth of material required for certification and practice of general surgery, highlighted by detailed, full-color intraoperative illustrations and high-quality video clips.
1. Introduction - p. 1 2. Chapter 1. The Rise of Modern Surgery:: An Overview - p. 2 3. Chapter 2. Ethics and Professionalism in Surgery - p. 20 4. Chapter 3. The Inflammatory Response - p. 26 5. Chapter 4. Shock, Electrolytes, and Fluid - p. 44 6. History - p. 45 7. Physiology of Shock - p. 49 8. Problems with Resuscitation - p. 62 9. Evolution of Modern Resuscitation - p. 66 10. Current Status of Fluid Types - p. 72 11. Future Resuscitation Research - p. 75 12. Perioperative Fluid Management - p. 80 13. Electrolytes - p. 83 14. Chapter 5. Metabolism in Surgical Patients - p. 95 15. Chapter 6. Wound Healing - p. 119 16. Chapter 7. Regenerative Medicine - p. 150 17. Chapter 8. Critical Assessment of Surgical Outcomes and Health Services Research - p. 159 18. Chapter 9. Safety in the Surgical Environment - p. 170 19. Section II. Perioperative Management - p. 185 20. Introduction - p. 186 21. Chapter 10. Principles of Preoperative and Operative Surgery - p. 187 22. Chapter 11. Surgical Infections and Antibiotic Use - p. 223 23. Chapter 12. Surgical Complications - p. 238 24. Wound Complications - p. 239 25. Thermal Regulation - p. 244 26. Respiratory Complications - p. 247 27. Cardiac Complications - p. 252 28. Renal and Urinary Complications - p. 256 29. Endocrine Dysfunction - p. 259 30. Gastrointestinal Complications - p. 262 31. Hepatobiliary Complications - p. 274 32. Neurologic Complications - p. 275 33. Ear, Nose, and Throat Complications - p. 278 34. The Geriatric Patient and Frailty - p. 279 35. Chapter 13. Surgery in the Geriatric Patient - p. 284 36. Chapter 14. Anesthesiology Principles, Pain Management, and Conscious Sedation - p. 315 37. Chapter 15. Emerging Technology in Surgery: Informatics, Electronics - p. 349 38. Chapter 16. Robotic Surgery - p. 362 39. Section III. Trauma and Critical Care - p. 384.e1 40. Introduction - p. 385 41. Chapter 17. Management of Acute Trauma - p. 386 42. Chapter 18. The Difficult Abdominal Wall - p. 429 43. Chapter 19. Emergency Care of Musculoskeletal Injuries - p. 440 44. Chapter 20. Burns - p. 484 45. Chapter 21. Bites and Stings - p. 506 46. Chapter 22. Surgical Critical Care - p. 521 47. Chapter 23. Bedside Surgical Procedures - p. 546 48. Chapter 24. The Surgeon’s Role in Mass Casualty Incidents - p. 555 49. Section IV. Transplantation and Immunology - p. 570 50. Introduction - p. 570 51. Chapter 25. Transplantation Immunobiology and Immunosuppression - p. 572 52. Chapter 26. Liver Transplantation - p. 614 53. Chapter 27. Kidney and Pancreas Transplantation - p. 627 54. Chapter 28. Small Bowel Transplantation - p. 644 55. Section V. Surgical Oncology - p. 654 56. Introduction - p. 655 57. Chapter 29. Tumor Biology and Tumor Markers - p. 656 58. Chapter 30. Tumor Immunology and Immunotherapy - p. 687 59. Chapter 31. Melanoma and Cutaneous Malignancies - p. 705 60. Chapter 32. Soft Tissue Sarcoma - p. 734 61. Chapter 33. Bone Tumors - p. 754 62. Section VI. Head and Neck - p. 769 63. Introduction - p. 770 64. Chapter 34. Head and Neck - p. 771 65. Section VII. Breast - p. 807 66. Introduction - p. 808 67. Chapter 35. Diseases of the Breast - p. 809 68. Anatomy - p. 809 69. Microscopic Anatomy - p. 812 70. Breast Development and Physiology - p. 813 71. Diagnosis of Breast Disease - p. 815 72. Breast Imaging - p. 817 73. Identification and Care of High-Risk Patients - p. 819 74. Benign Breast Tumors and Related Diseases - p. 825 75. Epidemiology and Pathology of Breast Cancer - p. 827 76. Staging of Breast Cancer - p. 832 77. Surgical Treatment of Breast Cancer - p. 834 78. Treatment of Ductal Carcinoma in Situ - p. 843 79. Radiation Therapy for Breast Cancer - p. 845 80. Systemic Therapy for Breast Cancer - p. 845 81. Treatment of Locally Advanced and Inflammatory Breast Cancer - p. 851 82. Treatment of Special Conditions - p. 851 83. Chapter 36. Breast Reconstruction - p. 856 84. Section VIII. Endocrine - p. 871 85. Introduction - p. 872 86. Chapter 37. Thyroid - p. 873 87. Chapter 38. The Parathyroid Glands - p. 921 88. Chapter 39. Endocrine Pancreas - p. 941 89. Chapter 40. The Adrenal Glands - p. 964 90. Chapter 41. The Multiple Endocrine Neoplasia Syndromes - p. 998 91. Section IX. Esophagus - p. 1012 92. Introduction - p. 1013 93. Chapter 42. Esophagus - p. 1014 94. Chapter 43. Gastroesophageal Reflux Disease and Hiatal Hernia - p. 1056 95. Section X. Abdomen - p. 1078.e1 96. Introduction - p. 1079 97. Chapter 44. Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum and Retroperitoneum - p. 1080 98. Chapter 45. Hernias - p. 1105 99. Chapter 46. Acute Abdomen - p. 1134 100. Chapter 47. Acute Gastrointestinal Hemorrhage - p. 1150 101. Chapter 48. Morbid Obesity - p. 1167 102. Chapter 49. Stomach - p. 1196 103. Anatomy - p. 1196 104. Physiology - p. 1199 105. Peptic Ulcer Disease - p. 1205 106. Stress Gastritis - p. 1216 107. Postgastrectomy Syndromes - p. 1217 108. Gastric Cancer - p. 1219 109. Other Gastric Lesions - p. 1235 110. Chapter 50. Small Intestine - p. 1240 111. Embryology - p. 1240 112. Anatomy - p. 1241 113. Physiology - p. 1244 114. Motility - p. 1247 115. Endocrine Function - p. 1248 116. Immune Function - p. 1248 117. Obstruction - p. 1250 118. Inflammatory and Infectious Diseases - p. 1258 119. Neoplasms - p. 1273 120. Diverticular Disease - p. 1286 121. Miscellaneous Problems - p. 1290 122. Chapter 51. The Appendix - p. 1301 123. Chapter 52. Colon and Rectum - p. 1320 124. Embryology of the Colon and Rectum - p. 1320 125. Anatomy of the Colon, Rectum, and Pelvic Floor - p. 1320 126. Physiology of the Colon - p. 1329 127. Preoperative Evaluation - p. 1333 128. Enhanced Recovery Protocols - p. 1336 129. Diverticular Disease - p. 1337 130. Large Bowel Obstruction - p. 1340 131. Colonic Pseudo-Obstruction - p. 1342 132. Inflammatory Bowel Disease - p. 1344 133. Infectious Colitis - p. 1355 134. Other Colonic Infections - p. 1357 135. Ischemic Colitis - p. 1358 136. Neoplasia - p. 1361 137. Colorectal Polyps - p. 1365 138. Staging - p. 1374 139. Surgical Treatment of Colorectal Cancer - p. 1374 140. Obstructing Colon Cancers - p. 1377 141. Rectal Cancer - p. 1378 142. Pelvic Floor Disorders and Constipation - p. 1389 143. Chapter 53. Anus - p. 1401 144. Chapter 54. The Liver - p. 1425 145. Historical Perspective - p. 1425 146. Anatomy and Physiology - p. 1426 147. Portal Hypertension - p. 1444 148. Infectious Diseases - p. 1451 149. Neoplasms - p. 1462 150. Hemobilia - p. 1480 151. Viral Hepatitis and the Surgeon - p. 1482 152. Chapter 55. Biliary System - p. 1489 153. Chapter 56. Exocrine Pancreas - p. 1528 154. Chapter 57. The Spleen - p. 1566 155. Section XI. Chest - p. 1582 156. Introduction - p. 1583 157. Chapter 58. Lung, Chest Wall, Pleura and Mediastinum - p. 1584 158. Anatomy - p. 1585 159. Selection of Patients for Thoracic Operations - p. 1588 160. Lung - p. 1590 161. Lung Cancer - p. 1594 162. Trachea - p. 1608 163. Pulmonary Infections - p. 1611 164. Massive Hemoptysis - p. 1616 165. Emphysema and Diffuse Lung Disease - p. 1617 166. Pulmonary Metastases - p. 1618 167. Miscellaneous Lung Tumors - p. 1619 168. Chest Wall - p. 1620 169. Thoracic Outlet Syndrome - p. 1627 170. Pleura - p. 1628 171. Mediastinum - p. 1632 172. Primary Mediastinal Cysts - p. 1634 173. Primary Mediastinal Neoplasms - p. 1635 174. Chapter 59. Congenital Heart Disease - p. 1641 175. Chapter 60. Acquired Heart Disease: Coronary Insufficiency - p. 1679 176. Chapter 61. Acquired Heart Disease: Valvular - p. 1711 177. Section XII. Vascular - p. 1742 178. Introduction - p. 1743 179. Chapter 62. The Aorta - p. 1744 180. Chapter 63. Peripheral Arterial Disease - p. 1767 181. Chapter 64. Vascular Trauma - p. 1792 182. Chapter 65. Venous Disease - p. 1812 183. Chapter 66. The Lymphatics - p. 1834 184. Section XIII. Specialties in General Surgery - p. 1842 185. Introduction - p. 1843 186. Chapter 67. Pediatric Surgery - p. 1844 187. Chapter 68. Neurosurgery - p. 1883 188. Chapter 69. Plastic Surgery - p. 1916 189. Chapter 70. Hand Surgery - p. 1945 190. Chapter 71. Gynecologic Surgery - p. 1999 191. Chapter 72. Surgery in the Pregnant Patient - p. 2026 192. Chapter 73. Fetal Surgery - p. 2050 193. Chapter 74. Urologic Surgery - p. 2061 194. Index - p. 2101
For more than 80 years, Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice has been the go-to text for trainees and surgeons at all levels of experience for definitive guidance on every aspect of general surgery. As the oldest continuously published textbook of surgery in North America, this fully revised 21st Edition continues to provide the key information, essential teaching pearls, and completely updated content needed to make the most informed surgical decisions and achieve optimal outcomes for patients. Concisely written and evidence based throughout, it covers the breadth of material required for certification and practice of general surgery, highlighted by detailed, full-color intraoperative illustrations and high-quality video clips.
1. Introduction - p. 1 2. Chapter 1. The Rise of Modern Surgery:: An Overview - p. 2 3. Chapter 2. Ethics and Professionalism in Surgery - p. 20 4. Chapter 3. The Inflammatory Response - p. 26 5. Chapter 4. Shock, Electrolytes, and Fluid - p. 44 6. History - p. 45 7. Physiology of Shock - p. 49 8. Problems with Resuscitation - p. 62 9. Evolution of Modern Resuscitation - p. 66 10. Current Status of Fluid Types - p. 72 11. Future Resuscitation Research - p. 75 12. Perioperative Fluid Management - p. 80 13. Electrolytes - p. 83 14. Chapter 5. Metabolism in Surgical Patients - p. 95 15. Chapter 6. Wound Healing - p. 119 16. Chapter 7. Regenerative Medicine - p. 150 17. Chapter 8. Critical Assessment of Surgical Outcomes and Health Services Research - p. 159 18. Chapter 9. Safety in the Surgical Environment - p. 170 19. Section II. Perioperative Management - p. 185 20. Introduction - p. 186 21. Chapter 10. Principles of Preoperative and Operative Surgery - p. 187 22. Chapter 11. Surgical Infections and Antibiotic Use - p. 223 23. Chapter 12. Surgical Complications - p. 238 24. Wound Complications - p. 239 25. Thermal Regulation - p. 244 26. Respiratory Complications - p. 247 27. Cardiac Complications - p. 252 28. Renal and Urinary Complications - p. 256 29. Endocrine Dysfunction - p. 259 30. Gastrointestinal Complications - p. 262 31. Hepatobiliary Complications - p. 274 32. Neurologic Complications - p. 275 33. Ear, Nose, and Throat Complications - p. 278 34. The Geriatric Patient and Frailty - p. 279 35. Chapter 13. Surgery in the Geriatric Patient - p. 284 36. Chapter 14. Anesthesiology Principles, Pain Management, and Conscious Sedation - p. 315 37. Chapter 15. Emerging Technology in Surgery: Informatics, Electronics - p. 349 38. Chapter 16. Robotic Surgery - p. 362 39. Section III. Trauma and Critical Care - p. 384.e1 40. Introduction - p. 385 41. Chapter 17. Management of Acute Trauma - p. 386 42. Chapter 18. The Difficult Abdominal Wall - p. 429 43. Chapter 19. Emergency Care of Musculoskeletal Injuries - p. 440 44. Chapter 20. Burns - p. 484 45. Chapter 21. Bites and Stings - p. 506 46. Chapter 22. Surgical Critical Care - p. 521 47. Chapter 23. Bedside Surgical Procedures - p. 546 48. Chapter 24. The Surgeon’s Role in Mass Casualty Incidents - p. 555 49. Section IV. Transplantation and Immunology - p. 570 50. Introduction - p. 570 51. Chapter 25. Transplantation Immunobiology and Immunosuppression - p. 572 52. Chapter 26. Liver Transplantation - p. 614 53. Chapter 27. Kidney and Pancreas Transplantation - p. 627 54. Chapter 28. Small Bowel Transplantation - p. 644 55. Section V. Surgical Oncology - p. 654 56. Introduction - p. 655 57. Chapter 29. Tumor Biology and Tumor Markers - p. 656 58. Chapter 30. Tumor Immunology and Immunotherapy - p. 687 59. Chapter 31. Melanoma and Cutaneous Malignancies - p. 705 60. Chapter 32. Soft Tissue Sarcoma - p. 734 61. Chapter 33. Bone Tumors - p. 754 62. Section VI. Head and Neck - p. 769 63. Introduction - p. 770 64. Chapter 34. Head and Neck - p. 771 65. Section VII. Breast - p. 807 66. Introduction - p. 808 67. Chapter 35. Diseases of the Breast - p. 809 68. Anatomy - p. 809 69. Microscopic Anatomy - p. 812 70. Breast Development and Physiology - p. 813 71. Diagnosis of Breast Disease - p. 815 72. Breast Imaging - p. 817 73. Identification and Care of High-Risk Patients - p. 819 74. Benign Breast Tumors and Related Diseases - p. 825 75. Epidemiology and Pathology of Breast Cancer - p. 827 76. Staging of Breast Cancer - p. 832 77. Surgical Treatment of Breast Cancer - p. 834 78. Treatment of Ductal Carcinoma in Situ - p. 843 79. Radiation Therapy for Breast Cancer - p. 845 80. Systemic Therapy for Breast Cancer - p. 845 81. Treatment of Locally Advanced and Inflammatory Breast Cancer - p. 851 82. Treatment of Special Conditions - p. 851 83. Chapter 36. Breast Reconstruction - p. 856 84. Section VIII. Endocrine - p. 871 85. Introduction - p. 872 86. Chapter 37. Thyroid - p. 873 87. Chapter 38. The Parathyroid Glands - p. 921 88. Chapter 39. Endocrine Pancreas - p. 941 89. Chapter 40. The Adrenal Glands - p. 964 90. Chapter 41. The Multiple Endocrine Neoplasia Syndromes - p. 998 91. Section IX. Esophagus - p. 1012 92. Introduction - p. 1013 93. Chapter 42. Esophagus - p. 1014 94. Chapter 43. Gastroesophageal Reflux Disease and Hiatal Hernia - p. 1056 95. Section X. Abdomen - p. 1078.e1 96. Introduction - p. 1079 97. Chapter 44. Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum and Retroperitoneum - p. 1080 98. Chapter 45. Hernias - p. 1105 99. Chapter 46. Acute Abdomen - p. 1134 100. Chapter 47. Acute Gastrointestinal Hemorrhage - p. 1150 101. Chapter 48. Morbid Obesity - p. 1167 102. Chapter 49. Stomach - p. 1196 103. Anatomy - p. 1196 104. Physiology - p. 1199 105. Peptic Ulcer Disease - p. 1205 106. Stress Gastritis - p. 1216 107. Postgastrectomy Syndromes - p. 1217 108. Gastric Cancer - p. 1219 109. Other Gastric Lesions - p. 1235 110. Chapter 50. Small Intestine - p. 1240 111. Embryology - p. 1240 112. Anatomy - p. 1241 113. Physiology - p. 1244 114. Motility - p. 1247 115. Endocrine Function - p. 1248 116. Immune Function - p. 1248 117. Obstruction - p. 1250 118. Inflammatory and Infectious Diseases - p. 1258 119. Neoplasms - p. 1273 120. Diverticular Disease - p. 1286 121. Miscellaneous Problems - p. 1290 122. Chapter 51. The Appendix - p. 1301 123. Chapter 52. Colon and Rectum - p. 1320 124. Embryology of the Colon and Rectum - p. 1320 125. Anatomy of the Colon, Rectum, and Pelvic Floor - p. 1320 126. Physiology of the Colon - p. 1329 127. Preoperative Evaluation - p. 1333 128. Enhanced Recovery Protocols - p. 1336 129. Diverticular Disease - p. 1337 130. Large Bowel Obstruction - p. 1340 131. Colonic Pseudo-Obstruction - p. 1342 132. Inflammatory Bowel Disease - p. 1344 133. Infectious Colitis - p. 1355 134. Other Colonic Infections - p. 1357 135. Ischemic Colitis - p. 1358 136. Neoplasia - p. 1361 137. Colorectal Polyps - p. 1365 138. Staging - p. 1374 139. Surgical Treatment of Colorectal Cancer - p. 1374 140. Obstructing Colon Cancers - p. 1377 141. Rectal Cancer - p. 1378 142. Pelvic Floor Disorders and Constipation - p. 1389 143. Chapter 53. Anus - p. 1401 144. Chapter 54. The Liver - p. 1425 145. Historical Perspective - p. 1425 146. Anatomy and Physiology - p. 1426 147. Portal Hypertension - p. 1444 148. Infectious Diseases - p. 1451 149. Neoplasms - p. 1462 150. Hemobilia - p. 1480 151. Viral Hepatitis and the Surgeon - p. 1482 152. Chapter 55. Biliary System - p. 1489 153. Chapter 56. Exocrine Pancreas - p. 1528 154. Chapter 57. The Spleen - p. 1566 155. Section XI. Chest - p. 1582 156. Introduction - p. 1583 157. Chapter 58. Lung, Chest Wall, Pleura and Mediastinum - p. 1584 158. Anatomy - p. 1585 159. Selection of Patients for Thoracic Operations - p. 1588 160. Lung - p. 1590 161. Lung Cancer - p. 1594 162. Trachea - p. 1608 163. Pulmonary Infections - p. 1611 164. Massive Hemoptysis - p. 1616 165. Emphysema and Diffuse Lung Disease - p. 1617 166. Pulmonary Metastases - p. 1618 167. Miscellaneous Lung Tumors - p. 1619 168. Chest Wall - p. 1620 169. Thoracic Outlet Syndrome - p. 1627 170. Pleura - p. 1628 171. Mediastinum - p. 1632 172. Primary Mediastinal Cysts - p. 1634 173. Primary Mediastinal Neoplasms - p. 1635 174. Chapter 59. Congenital Heart Disease - p. 1641 175. Chapter 60. Acquired Heart Disease: Coronary Insufficiency - p. 1679 176. Chapter 61. Acquired Heart Disease: Valvular - p. 1711 177. Section XII. Vascular - p. 1742 178. Introduction - p. 1743 179. Chapter 62. The Aorta - p. 1744 180. Chapter 63. Peripheral Arterial Disease - p. 1767 181. Chapter 64. Vascular Trauma - p. 1792 182. Chapter 65. Venous Disease - p. 1812 183. Chapter 66. The Lymphatics - p. 1834 184. Section XIII. Specialties in General Surgery - p. 1842 185. Introduction - p. 1843 186. Chapter 67. Pediatric Surgery - p. 1844 187. Chapter 68. Neurosurgery - p. 1883 188. Chapter 69. Plastic Surgery - p. 1916 189. Chapter 70. Hand Surgery - p. 1945 190. Chapter 71. Gynecologic Surgery - p. 1999 191. Chapter 72. Surgery in the Pregnant Patient - p. 2026 192. Chapter 73. Fetal Surgery - p. 2050 193. Chapter 74. Urologic Surgery - p. 2061 194. Index - p. 2101
