|Year : 2020 | Volume
| Issue : 6 | Page : 421-422
IAPS textbook of pediatric surgery
John G Raffensperger
Emeritus Professor, Department of Pediatric Surgery, Northwestern University Medical School, Illinois, USA
|Date of Submission||25-Sep-2020|
|Date of Acceptance||25-Sep-2020|
|Date of Web Publication||27-Oct-2020|
Prof. John G Raffensperger
14890 David Drive, Fort Meyers, FL. 33908
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Raffensperger JG. IAPS textbook of pediatric surgery. J Indian Assoc Pediatr Surg 2020;25:421-2
Title : IAPS Textbook of Pediatric Surgery
Editors : Rajeev Redkar (Editor-in-chief), Prakash Agarwal, V Raveenthiran, Shirin Joshi Gosavi, Anant Bangar
Paperback : 962 pages
ISBN-10 : 9389587506
ISBN-13 : 978-9389587500
Publisher : Jaypee Brothers Medical Publishers
Year : January 2020
Edition : 1st
Language : English
Price : MRP ₹ 4,395
The Indian Association of Pediatric Surgeons (IAPS) Textbook of Pediatric Surgery is comprehensive, up to date, and filled with elegant full-color illustrations. There are extensive references for each chapter. The editors of this exhaustive volume drew on the expertise of Indian pediatric surgeons, all professors, or consultants at outstanding institutions. A few contributors are professors in the United Kingdom or the United States. India has the world's largest population of children, and the pediatric surgeons of India have the world's highest volume of pediatric surgical patients. This rich experience is evident in each chapter of the book.
The editors pay tribute to the founders of the IAPS, especially to Dr. Suibhash J. Dalal, who during the 1950s became a surgical registrar at a children's hospital in charge of 100 beds. He later visited pediatric surgical centers in the United States and, upon returning to India, established his practice in Mumbai.
The book is organized by sections on general topics, trauma, organ systems, oncology, urology, transplantation, and miscellaneous. There is some redundancy among chapters, but this is to be expected in multi-authored books. The chapters on fetal medicine, counseling, and surgery could have been condensed into one chapter. The chapter on fluid therapy includes an excellent discussion of basic science but omits the classic signs of dehydration, such as poor skin turgor, sunken eyes, dry mucous membranes, and a low urine output. There is no mention of body weight. A child's current weight as compared with his birth weight or previously known weight will provide valuable information as to the amount of fluid loss. The chapters on septic shock and burns advise resuscitation with large amounts of saline or Ringer's lactate solution. This concept of resuscitation with large volumes of crystalloids is based upon the research by the United States Army in healthy males who suffered trauma. Does this research apply to sick infants and children? Large amounts of saline solution may rescue the patient from shock, but there is a leakage of fluid into the extravascular space, edema, and hypoproteinemia. Transfusions of fresh blood or fresh frozen plasma obviate this problem and they will provide globulin which may combat infection.
The illustrations depicting the management of cardiac arrest are superb and should be in the poster form on the walls of emergency rooms and in the intensive care unit. The section on trauma would be improved with chapters on extremity injuries, fractures, neonatal trauma, and penetrating injuries of the chest and abdomen.
The chapter on congenital diaphragmatic hernia stresses the high technology found in sophisticated tertiary surgical centers. In areas where neonatal transport is difficult or slow, a baby with this defect may be well served with techniques developed 70 years ago. Replacing herniated intestine into the abdominal cavity increases intra-abdominal pressure, reduces cardiac output, and splints the diaphragm. Sudden removal of air from the affected pleural cavity with a chest drain will overexpand and damage the opposite lung. In the past years, pediatric surgeons quickly resuscitated the infant, made every attempt to maintain spontaneous respiration, and operated through a vertical abdominal incision. With this incision, large defects may be closed with a flap of the transversus abdominalis muscle obviating a plastic patch. A small catheter connected to a syringe allows the withdrawal or injection of air into the pleural cavity to prevent movement of the mediastinum and over-expansion of the opposite lung. The skin is undermined for a centimeter on either side and closed, leaving the peritoneum and fascia open to decrease intra-abdominal pressure.
The all-inclusive section on abdominal disease might have included a discussion on the prevention and treatment of postoperative adhesive intestinal obstruction. At the very least, we should remind young surgeons to rinse away every bit of powder from their gloves and to avoid using small gauze sponges in the peritoneal cavity. The practice of holding the intestine with gauze sponges damages the epithelium and leaves particles of cotton that incites an inflammatory reaction. We must, at the risk of daily repetition, remind our assistants to ligate or cauterize only the vessel but not great bites of the tissue. Strict attention to these seemingly trivial details may avoid adhesive obstructions.
It would have been helpful to include the institutional or individual surgeon's results. This is especially true with Hirschprung's disease, because, throughout the world, the incidence of postoperative fecal incontinence appears to be on the rise.
The book gives considerable space to topics such as robotic surgery, fetal medicine, ECMO, transplantation, and other high technology. In an era when pediatric surgeons may be faced with earthquakes, hurricanes, and border warfare when the electricity fails should there not be mention of 'disaster surgery'? One can remove a ruptured appendix or repair a compound fracture with drop ether anesthesia, an antiseptic, a scalpel, tissue forceps, a few hemostats, scissors, a spool of silk thread, and sewing needles.
Despite my trivial criticism, the IAPS Textbook of Pediatric Surgery is an absolutely outstanding volume. I hope that it is made available to surgeons outside India.
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Conflicts of interest
There are no conflicts of interest.