Part of the Integrating Palliative Care series, this volume on surgical palliative care guides readers through the core palliative skills and knowledge needed to deliver high value care for patients with life-limiting, critical, and terminal illness under surgical care. Surgical Palliative Care is an ideal resource for surgeons, surgical nurses, intensivists, and other practitioners who wish to learn more about integrating palliative care into the surgical field.

Palliative surgery can greatly contribute to improving symptom control and quality of life for terminal cancer patients. Owing to the advanced stage of the disease, however, this type of surgery is also associated with significant morbidity and mortality. It is therefore important for surgeons to have a sound understanding of the medical and scientific background underlying treatment decisions in palliative surgery, a foundation that this book provides. The opening chapters examine the relationship between palliative medicine and palliative surgery and address general issues including pain management and anesthesiological considerations. The role of palliative surgery in a wide range of disease settings is then thoroughly explored, including detailed information on surgical techniques and their indications and outcomes. This book will be an invaluable resource for all who wish to learn more about the emerging role of palliative surgery.

This comprehensive yet concise book addresses current best practice in the combined areas of cardiac surgery and anesthesia, interventional minimally invasive cardiac procedures, perioperative management and monitoring, and critical care recovery. This book not only provides the latest best practices in the perioperative management of cardiac surgical patients, but also it summarizes the current clinical guidelines and algorithms from leading cardiac programs and professional societies. Contemporary best practice approaches are written by experts from leading cardiac surgical centers. The preoperative, intraoperative and postoperative management and recovery of surgical patients, including medication, monitoring techniques, and innovative surgical procedures, are presented by experts in the field of cardiac anesthesia and surgery. Perioperative clinical care guidelines, postoperative recovery pathways and models of care are presented with supporting protocols. Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery is aimed at all cardiac anesthesiology consultants, fellows, and trainees; all cardiac surgery consultants, fellows, and trainees; nurses in perioperative care and those involved in patient recovery management; cardiac program administrative professionals; and all critical care consultants and trainees looking after cardiovascular surgical patients in the modern era.

This book covers all essential evidence on perioperative care and anesthetic concerns for cancer surgeries, including the evaluation and assessment of patients’ schedule for cancer surgeries, perioperative anesthetic management of various cancers, perioperative analgesia for cancer surgeries, and issues related to inoperable cancers. It reviews anesthetic considerations of all cancer types as there is a wide variation in anesthetic requirements in this subset of patients. Cancer surgeries are on the rise worldwide and healthcare facilities with cancer as a core specialty are emerging quickly around the globe. As cancer is on rise and efficient surgical management is available, more and more patients are being treated surgically. However, cancer surgeries are complicated, have varied concerns and these are not covered sufficiently in presently available textbooks of anesthesiology. This book fulfills the growing need for complete and comprehensive textbook of onco-anesthesia and fills the gap in the current texts that do not exclusively cover anesthesia for cancer surgeries. This textbook serves as a comprehensive but quick guide for trainee residents/fellows and practicing anesthesiologists, clinicians and surgeons.

This book provides a detailed guide to the ethical considerations involved when making decisions in surgery. Chapters feature a uniform format, which feature a case that represents a real-life problem, discussion of the medical indications of that issue, the latest available medical solutions, and related ethical considerations. In some cases, more in-depth debate is provided on why a particular decision should or should not be made based-upon ethical principles. Information boxes containing key statements and relevant data in clear easy-to-digest tables facilitates the reader in being able to assimilate the most important points covered in each chapter. Difficult Decisions in Surgical Ethics: An Evidence-Based Approach is a thorough review of ethical considerations in a range of surgical scenarios encompassing both adult and pediatric topics, training surgical residents, ethical care during a pandemic, critical care, palliative care, sensitivity to religious and ethnic mores, clinical research, and innovation. It is intended to be a vital resource for practicing and trainee surgeons seeking a comprehensive up-to-date resource on ethical topics in surgical practice. The work is part of the Difficult Decisions in Surgery series covering a range of surgical specialties.

Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.

Surgical Palliative Care describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, withincreasingly minimal access techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgicaloption. The text is divided into two sections; the first dealing with general issues, varying from quality of life measurement to spirituality, and the second illustrating their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeonsto change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms. Aimed primarily at palliative medicine and pain consultants, this book will also appeal to surgeons who increasingly need to know more about palliativecare.

Symptom control, management of psychosocial and spiritual concerns, decision-making consistent with values and goals, and care of the imminently dying that is appropriate and sensitive are among the critical issues in palliative care. This book explores progress made and future goals.

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

THE LANDMARK GUIDE TO ADULT CARDIAC, CONGENITAL CARDIAC, AND GENERAL THORACIC SURGERY--COMPLETELY UPDATED AND REVISED IN FULL COLOR An essential guide for daily clinical practice and a thorough review for the cardiothoracic boards, Johns Hopkins Textbook of Cardiothoracic Surgery is filled with authoritative guidance on surgical techniques and pre- and postoperative strategies for managing cardiothoracic disease. The content of this trusted classic reflects the rapidly changing field of cardiothoracic surgery. In addition to the basic curriculum required for certification, you will find coverage of advanced concepts, controversial issues, and new technologies. Johns Hopkins Textbook of Cardiothoracic Surgery provides an in-depth look at the full-spectrum of disorders and their surgical and medical management options, including congenital, acquired, and neoplastic diseases. Supporting this detailed coverage is an easy-to-navigate design and step-by-step explanations of the most complex operations. THE SECOND EDITION IS HIGHLIGHTED BY: NEW board review Q&A Ten NEW chapters including: Surgical Therapies for Atrial Fibrillation, Management of Adults with Congenital Heart Disease, and Stem Cells for Cardiac Surgical Disease NEW full-color illustrations An increased number of decision-making flow charts that will prove valuable when preparing for cases and examinations Key Concepts that highlight epidemiology, pathophysiology, clinical features, diagnostic and treatment strategies, and outcomes for each topic NOTE: This book was previously known as the Johns Hopkins Manual of Cardiothoracic Surgery but the second edition has been renamed to better reflect its scope and comprehensive nature.