1
Book reviews Hepatic and Biliary Cancer H. J. Wunebo. 235 x 155 mm. Pp. 549 +.~xxv. Illustrated. 1987. New York: Dekker lnc. $89.75. This excellently produced multi-author book has chapters covering all of the main topics in hepatic and biliary cancer, each written by a leading authority. Most of the work is from the United States but there are important contributions from England, Japan and France. The book is billed as the first up-to-date, comprehensive source-book of its type, and as providing a broad-based view of this crucial area of research and practice. It is subdivided into three main sections on cancer of the liver,cancer of the extrahepatic bile ducts and cancer of the gallbladder with a final section on special topics. Although each chapter is of interest and the majority well written, they are essentially individual papers by experts. The overall impression is therefore somewhat disjointed. The ordinary practising surgeon, radiotherapist or oncologist will not find it easy to obtain useful advice to help in the management of an individual patient. It is a pity that clear recommendations on management are not given, other than in the final overview chapter by the Editor. The primary liver cancer section contains excellent chapters on radiological techniques and angiography for diagnosis. This section occupies 278 pages and surgeons may find the detail excessive. Clear recommendations on management are difficult to find, probably because the treatment of most patients is so disappointing. There are excellent essays by various experts on extrahepatic bile duct carcinoma which in many instances up-dates their previous reports. Difficulties in management are highlighted as are the disappointing overall results irrespective of the treatment used. The outlook for most patients with cancer ofthegallbladder remains dismal. In the final section there are excellent reviews on the surgical management of liver metastases and the current place of hepatic transplantation for primary carcinoma of the liver. The very limited role of transplantation is highlighted. The book is an essential acquisition for allmajor hospital libraries. It is unlikely to be of specific interest to the average practising surgeon, but will be important reading for those with a particular interest in hepatic and biliary cancer. J. Terblanche Aids to Operative Surgery G. J. Poston, 215 x 135 mm. Pp. 214. 1986. Edinburgh: Churchill Licingstone. f7.95. This latest offering in the ‘Aids to’ series, will, I am sure, find its way into the hearts and the pockets of many young surgeons coming up to final fellowship. It is a book that many of us would have liked to have written and credit should go to Mr Poston for producing both exhaustive and exhausting lists. However, a word ofcaution is necessary for the unwary candidate. Although many of the generalizations would be acceptable to most examiners, some of the specific details are no more than personal prejudice and may stimulate unwanted controversy. Indeed there is a potential danger that Lists become learnt by constant recital rather than by theatre experience. Some of thecontent is disappointing, for instance the whole of breast surgery is reduced to a single operation ~ a rather scanty description of simple mastectomy with axillary sampling. Moreover there is too great an emphasis on pre-operative investigations at the expense of operative technique. At f7.95 the book is excellent value; however, 1 fear the binding will lead to wider dissemination of the information than is intended. I think the publishers could have left blank space after each procedure for the diligant trainee to add pertinent comments. M. W. Kissin Pathology for Surgeons P. C. H. Watt and R. A. J. Spence. 240 x 160 mm. Pp. 707txc. Illustrated. 1986. Bristol: Wright. 535.00. The authors are to be complimented on writing a comprehensive text covering a wide range of pathology relevant to surgery. The book contains almost 700 pages but is easy to handle and read. It is well set out and gives due reference to the modern approach in certain areas e.g. lymphoma, carcinoma of the stomach and breast. As a summary of pathology for FRCS candidates and undergraduates this book is clear and concise. A good and successful feature is to introduce each chapter with a summary of relevant anatomy and physiology. I liked the diagrams, which are very clear and amplify the text, but some of the photographs illustrating specimens have not reproduced very well. The publishers suggest that the book will be welcomed by more senior surgeons as a reference book but at this level it is not successful because it presents a didactic view over a very wide field of pathology. Although the book is basically sound, some of the statements are, at least, questionable e.g. ‘external fistulae occur in about a quarter of the patients with Crohn’s disease’. Nevertheless, it is a good book for the junior surgeon and quite reasonably priced at f35. P. F. Schofield Surgical, Diagnostic and Therapeutic Instruments J. J. Stanek. 220 x 185 mm. Pp. 166 fuiii. Illustrated. 1986. Oxford: Blackwell Scientijlc Publications. f24.50. This is a small book of 157 pages which is well produced and easy to read. It is divided into three sections-Diagnostic, Therapeutic and Operative instruments. It covers a wide range of topics in each section and, because of the limited space, only a very brief comment is made on each item. The description of each instrument follows a pattern including defintion, explanation, indications for use and technique. The very shortness of the book limits the number of alternatives that can be shown. There are usually simple drawings of a classical instrument but in some examples these have been omitted spoiling the overall pattern. The Author suggested his book would be useful to everybody from medical student up to senior surgeons and physicians and radiologists. I think this is incorrect. It is possible that senior medical students and FRCS candidates might like to skim through the pages as means of a quick refresher; however, anyone else interested in buying, using or even comparing instruments, would need to use a much mare detailed description. Many large catalogues are available for this purpose. A. A. Gunn Current Topics in Surgery. Volume 1 N. Rungubashyam. 250 x 190 mm. Pp. 144. Illustrated. 1986. Indiu: Macmillan tndia Ltd. Rs 175.00. It is inevitable that each School of Surgery wishes to publish a selection of essays outlining the current trends in the management of common conditions. The Indian School of Surgery is no exception, having probably a greater need to publish its own material than most, for the conditions which the Indian surgeon encounters differ markedly from those seen in most Western practices. This is well illustrated by the first edition of Current Topics in Surgery in which tuberculosis and amoebiasis take pride of place in the subjects chosen by the Editor. Alas, despite sterling efforts by the Editor, some chapters are pedestrian with a lack of up-to-date references and personal prejudices described but not substantiated by good data collection which is strongly advocated by Aluwihare in his chapter on Rectal Disease. I trust that this will be a forerunner of future editions, and that the Editor will feel able to call upon the younger surgeons who are beginning to stir Indian surgery, and direct it along a more objective and critical path. R. C. G. Russell 656 Br. J. Surg., Vol. 74, No. 7, July 1987

Aids to operative surgery. G. J. Poston, 215×135 mm. Pp. 214. 1986. Edinburgh: Churchill Livingstone. £7.95

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Book reviews

Hepatic and Biliary Cancer H . J . Wunebo. 235 x 155 mm. P p . 549 + . ~ x x v . Illustrated. 1987. N e w York: Dekker lnc. $89.75.

This excellently produced multi-author book has chapters covering all of the main topics in hepatic and biliary cancer, each written by a leading authority. Most of the work is from the United States but there are important contributions from England, Japan and France. The book is billed as the first up-to-date, comprehensive source-book of its type, and as providing a broad-based view of this crucial area of research and practice.

It is subdivided into three main sections on cancer of the liver,cancer of the extrahepatic bile ducts and cancer of the gallbladder with a final section on special topics. Although each chapter is of interest and the majority well written, they are essentially individual papers by experts. The overall impression is therefore somewhat disjointed. The ordinary practising surgeon, radiotherapist or oncologist will not find it easy to obtain useful advice to help in the management of an individual patient. It is a pity that clear recommendations on management are not given, other than in the final overview chapter by the Editor.

The primary liver cancer section contains excellent chapters on radiological techniques and angiography for diagnosis. This section occupies 278 pages and surgeons may find the detail excessive. Clear recommendations on management are difficult to find, probably because the treatment of most patients is so disappointing.

There are excellent essays by various experts on extrahepatic bile duct carcinoma which in many instances up-dates their previous reports. Difficulties in management are highlighted as are the disappointing overall results irrespective of the treatment used. The outlook for most patients with cancer ofthegallbladder remains dismal.

In the final section there are excellent reviews on the surgical management of liver metastases and the current place of hepatic transplantation for primary carcinoma of the liver. The very limited role of transplantation is highlighted.

The book is an essential acquisition for allmajor hospital libraries. It is unlikely to be of specific interest to the average practising surgeon, but will be important reading for those with a particular interest in hepatic and biliary cancer.

J. Terblanche

Aids to Operative Surgery G . J . Poston, 215 x 135 mm. P p . 214. 1986. Edinburgh: Churchill Licingstone. f7.95.

This latest offering in the ‘Aids to’ series, will, I am sure, find its way into the hearts and the pockets of many young surgeons coming up to final fellowship. It is a book that many of us would have liked to have written and credit should go to Mr Poston for producing both exhaustive and exhausting lists. However, a word ofcaution is necessary for the unwary candidate. Although many of the generalizations would be acceptable to most examiners, some of the specific details are no more than personal prejudice and may stimulate unwanted controversy. Indeed there is a potential danger that Lists become learnt by constant recital rather than by theatre experience.

Some of thecontent is disappointing, for instance the whole of breast surgery is reduced to a single operation ~ a rather scanty description of simple mastectomy with axillary sampling. Moreover there is too great an emphasis on pre-operative investigations at the expense of operative technique.

At f7.95 the book is excellent value; however, 1 fear the binding will lead to wider dissemination of the information than is intended. I think the publishers could have left blank space after each procedure for the diligant trainee to add pertinent comments.

M. W. Kissin

Pathology for Surgeons P. C . H. Watt and R . A . J . Spence. 240 x 160 mm. P p . 707txc. Illustrated. 1986. Bristol: Wright. 535.00.

The authors are to be complimented on writing a comprehensive text covering a wide range of pathology relevant to surgery. The book contains almost 700 pages but is easy to handle and read. It is well set out and gives due reference to the modern approach in certain areas e.g. lymphoma, carcinoma of the stomach and breast. As a summary of pathology for FRCS candidates and undergraduates this book is clear and concise. A good and successful feature is to introduce each chapter with a summary of relevant anatomy and physiology. I liked the diagrams, which are very clear and amplify the text, but some of the photographs illustrating specimens have not reproduced very well.

The publishers suggest that the book will be welcomed by more senior surgeons as a reference book but at this level it is not successful because it presents a didactic view over a very wide field of pathology. Although the book is basically sound, some of the statements are, at least, questionable e.g. ‘external fistulae occur in about a quarter of the patients with Crohn’s disease’. Nevertheless, it is a good book for the junior surgeon and quite reasonably priced at f35.

P. F. Schofield

Surgical, Diagnostic and Therapeutic Instruments J . J. Stanek. 220 x 185 mm. P p . 166 f u i i i . Illustrated. 1986. Oxford: Blackwell Scientijlc Publications. f24.50.

This is a small book of 157 pages which is well produced and easy to read. It is divided into three sections-Diagnostic, Therapeutic and Operative instruments. It covers a wide range of topics in each section and, because of the limited space, only a very brief comment is made on each item. The description of each instrument follows a pattern including defintion, explanation, indications for use and technique.

The very shortness of the book limits the number of alternatives that can be shown. There are usually simple drawings of a classical instrument but in some examples these have been omitted spoiling the overall pattern.

The Author suggested his book would be useful to everybody from medical student up to senior surgeons and physicians and radiologists. I think this is incorrect. It is possible that senior medical students and FRCS candidates might like to skim through the pages as means of a quick refresher; however, anyone else interested in buying, using or even comparing instruments, would need to use a much mare detailed description. Many large catalogues are available for this purpose.

A. A. Gunn

Current Topics in Surgery. Volume 1 N . Rungubashyam. 250 x 190 mm. P p . 144. Illustrated. 1986. Indiu: Macmillan tndia Ltd. Rs 175.00.

It is inevitable that each School of Surgery wishes to publish a selection of essays outlining the current trends in the management of common conditions. The Indian School of Surgery is no exception, having probably a greater need to publish its own material than most, for the conditions which the Indian surgeon encounters differ markedly from those seen in most Western practices. This is well illustrated by the first edition of Current Topics in Surgery in which tuberculosis and amoebiasis take pride of place in the subjects chosen by the Editor. Alas, despite sterling efforts by the Editor, some chapters are pedestrian with a lack of up-to-date references and personal prejudices described but not substantiated by good data collection which is strongly advocated by Aluwihare in his chapter on Rectal Disease. I trust that this will be a forerunner of future editions, and that the Editor will feel able to call upon the younger surgeons who are beginning to stir Indian surgery, and direct it along a more objective and critical path.

R. C. G. Russell

656 Br. J. Surg., Vol. 74, No. 7, July 1987