There is a growing need for a book on emergency general surgery in the elderly, as adults age 65 and older are the fastest growing segment of the population worldwide, and their number is expected to double to 89 million between now and 2050. Based on these changing demographics, it is expected that there will be a concurrent rise in the demand for a variety of surgical services, including vascular surgery (with a projected growth of 31%) and general surgery (with a projected growth of 18%), as well as in all sub-disciplines of surgery (thoracic, cardiac, oncology, hepatobiliary, transplant, plastic colorectal, orthopedic, gynecologic, urology and neurosurgery).In addition, older surgical patients often require a different level of care than younger patients during the preoperative, intraoperative and postoperative phases. Many of our geriatric population have multiple chronic illnesses beyond the one for which surgery is required, and therefore are prone to developing postoperative complications, functional decline, loss of independence, and other undesirable outcomes. In response, this book offers surgeons, geriatrists and nurses state-of-the-art surgical approaches and essential information on the complex perioperative care of the elderly.

The field of emergency general surgery encompasses a wide array of surgical diseases, ranging from the simple to the complex. These diseases may include inflammatory, infectious, and hemorrhagic processes spanning the entire gastrointestinal tract. Complications of abdominal wall hernias, compartment syndromes, skin and soft tissue infections, and surgical diseases are significantly complex in special populations, including elderly, obese, pregnant, immunocompromised, and cirrhotic patients. This book covers emergency general surgery topics in a succinct, practical and understandable fashion. After reviewing the general principles in caring for the emergency general surgery patient, this text discusses current evidence and the best practices stratified by organ system, including esophageal, gastroduodenal, hepatobiliary and pancreatic, small and large bowel, anorectal, thoracic, and hernias. Chapters are written by experts in the field and present a logical, straightforward, and easy to understand approach to the emergency general surgery patient, as well as provide patient care algorithms where appropriate. Emergency General Surgery: A Practical Approach provides surgeons and surgery residents with a practical and evidence-based approach to diagnosing and managing a wide array of surgical diseases encountered on emergency general surgery call.

This book is designed to present a comprehensive and state-of the-art approach to all aspects of geriatric surgery within the broad confines of surgery in geriatrics including general surgery, neurosurgery, thoracic surgery, vascular surgery, cardiac surgery, surgical oncology, hepatobiliary and transplant surgery, plastic, colorectal, orthopedic, gynecologic, and urologic surgery. The text is split into four parts. The first part is organized under general considerations on the geriatric surgical patient and includes current trends in geriatric surgery, and a number of important general issues such as practical approaches to reversal of bleeding/anticoagulation, role of anesthetic concerns in advanced age, frailty index and measurements of physiological reserves, nutritional support in the elderly, quality of life in the elderly, drug use, and family involvement. Part two of the book focuses on surgery specific system-based problems in geriatric surgical patients. The third part addresses many other important aspects of geriatric surgery including palliative and end of life care for the elderly, religious issues and the elderly care surgery, elderly with mental health issues, and nursing care of elderly patients. The fourth and final part describes the need for geriatric surgical care education and the components that are essential for the curriculum of current and future generations of students. Written by experts in the field, Surgical Decision Making in Geriatrics addresses patient selection, pre-operative considerations, technical conduct of the most common operations, and avoiding complications.

The global population is aging rapidly, and as a result emergency abdominal surgery for acute abdomen in the elderly has become a global issue. Demographic changes in the population have also altered the profile of emergency abdominal surgery, with typical causes of acute abdomen in the elderly including acute cholecystitis, incarcerated hernia, bowel obstruction and appendicitis. In these patients, recovery from surgery is often complicated, leading to longer hospital stays compared with younger patients. Laparoscopy in the emergency setting is well established and offers a number of advantages over open surgical approaches, such as reduced postoperative pain, length of hospital stay and complication rates. While laparoscopic surgery for acute diverticulitis has become more widespread, in other conditions, like small bowel obstruction and perforated peptic ulcer, laparotomy is still used in about 70% of cases. Further, despite the urgent need for knowledge regarding surgical treatment of acute abdomen in the elderly, there is still a lack of evidence in this relevant clinical field. This book analyzes the management strategies and critically evaluates the outcomes of laparoscopic emergency surgery for acute abdomen in the elderly according to the principles of evidence-based medicine. Discussing each topic clearly, and promoting the use of emergency laparoscopy in elderly patients, the book is intended for young general surgeons and surgeons in training with at least a basic knowledge of surgery for acute abdomen. It is also useful as a quick reference tool during on-call shifts.

This innovative, comprehensive book covers the key elements of perioperative management of older patients. The book's chapter structure coincides with the clinical path patients tread during their treatment, from preoperative evaluation to post-hospital care. Epidemiological aspects and aging processes are illustrated, providing keys to understanding the quick expansion of geriatric surgery and defining the clinical profile of older surgical patients in a cybernetic perspective. Preoperative evaluation and preparation for surgery, including medication reconciliation and pre-habilitation, are developed in the light of supporting decision-making about surgery in an evidence-based and patient-focused way. Intra- and postoperative management are discussed, aiming to tailor anesthetic, surgical and nursing approaches to specific patients' needs, in order to prevent both general and age-related complications. This volume also addresses issues relevant to geriatric surgery, from different organizational models to clinical risk management and systems engineering applied to hospital organization.

"In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be "geriatric surgeons," but to assemble a comprehensive account that will allow "all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients." This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field." NEJM Book Review

Incorporating and balancing advancing subspecialization is a significant challenge of modern surgery. The changes of surgical education and early subspecialization is a smaller spectrum of experience of graduating surgeons joining the rural workforce. Surgeons working in rural and remote hospitals, however, must be proficient in the great breadth of current surgical practice and face a number of challenges and demands that are specific to rural surgery. This textbook provides an update on the evidence and surgical techniques for the experienced rural surgeon and most importantly is a guideline for younger surgeons and surgical trainees joining the general surgical workforce in rural and remote areas around the world.

This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.

This text is designed to present a comprehensive, up to date and safe approach to managing emergency general surgery patients with a minimally invasive approach. This book bridges the gap between the minimally invasive surgery (MIS) expert who may not routinely be involved in the care of the acute care surgery patient and the ACS expert surgeon who may not have a routine MIS elective practice. The first section reviews the physiology of the acute care surgery patient and the physiologic impact of MIS techniques including pnemoperitoneum in critically ill patients. This review is crucial to assure that the surgeon has a clear understanding of when a MIS approach is safe and when it can be potentially dangerous to the patient. The illustrations are presented in an atlas-style format to describe the surgical procedures. The authors of the various sections are minimally invasive and acute care surgeons from prominent academic centers. The format represents a narrative review with appropriate illustrations and links to online videos.

Acute Care for Elders (ACE) is a model of care designed to improve functional outcomes and to improve the processes for the care of older patients. This model includes: an environment of care designed to promote improved function for older patients; an interdisciplinary team that works together to identify/address the vulnerabilities of the older patients; nursing care plans for prevention of disability; early planning to help prepare the patient to return home and a review of medical care to prevent iatrogenic illness. Acute Care for Elders: A Model for Interdisciplinary Care is an essential new resource aimed at assisting providers in developing and sustaining an ACE program. The interdisciplinary approach provides an introduction to the key vulnerabilities of older adults and defines the lessons learned from the Acute Care for Elders model. Expertly written chapters describe critical aspects of ACE: the interdisciplinary approach and the focus on function. The fundamental principles of ACE described in this book will further assist hospital leaders to develop, implement, sustain and disseminate the Acute Care for Elders model of care. Acute Care for Elders: A Model for Interdisciplinary Care is of great value to geriatricians, hospitalists, advance practice nurses, social workers and all others who provide high quality care to older patients.