Book reviews

Management of Oesophageal Carcinoma R. L . Hurt. 250 x 170 mm. Pp. 298. Illustrated. 1989. London: Springer Verlag. U5.00. This short book reviews the field of oesophageal cancer. It starts with a historical review which shows how recently the technical problems of resecting the oesophagus have been tackled with any success. Subsequent chapters discuss surgical anatomy, epidemiology, endo- scopic and radiological diagnosis. The remarkable regional variation in incidence of these tumours shows that it should be possible to learn something about their cause by epidemiological studies. Unfortunately areas of high incidence tend to be in countries where endoscopy and radiology (including CT and magnetic scanning) are not widely available. The section on pathology, however, shows that we are still some way from identifying specific carcinogens.

Chapters follow on surgical resection at different levels - postcricoid or intrathoracic. Different surgical techniques are fully described. There are good descriptions of operative technique, and of intubation, radiotherapy, and intracavitary radiation, cytotoxic therapy, and laser treatment. The treatment of complications is also extensively discussed.

The generally unsatisfactory results in this distressing condition - a mortality of l(t20 per cent following operations and 5 years survival of only 15-20 per cent -might lead to the conclusion that cases should be referred to specialist units where they would get better treatment than is generally available in our District General Hospitals. Since this idea runs contrary to tradition in the UK perhaps more would be achieved if the book were widely read by those of us who treat the cases which come our way. The cost of the volume (fX5.00) cannot be regarded as excessive if even one patient received cure, or palliation, as a result.

P. F. M. Wyllie

Academic Unit of Surgery Whitrington Hospital London N19 5NF UK

Basic Surgical Techniques R. M . Kirk. 185 x 120 mm. Pp. 304. Illustrated. 1989, Singapore: Churchill Livingstone. f9.95.

It you are a SHO who has just begun a surgical career then this may be the book you should browse through after your first few weeks in the job. It is not an operation manual but tells you a great deal about some of the very basic surgical manoeuvres which come naturally with time but which are not usually taught by more senior surgeons. It includes chapters on incisions, sutures, dissection and the handling of various types of tissues. It is a book which will be helpful for a short period at the start of training but will be rapidly replaced by the need for more specific operative manuals. Nevertheless this does not make its content less important.

P. A. Thomas

Consultant Surgeon Whipps Cross Hospital Leytonstone London El I UK

Year Book in Vascular Surgery J . J . Bergan, J . S . T . Yao. 235 x 155 mm. Pp. 327. Illustrated. 1989. St Louis: Mosby- Year Book Inc. €42.00.

The Year Book in Vascular Surgery series has, to date, been highly regarded, and this present volume will only serve to enhance the series’ reputation. Bergan, Yao and their colleagues have managed to sift the literature of a year for worthy material from sources which are surprisingly catholic, with the result that a genuinely international spread of work is displayed.

A volume like this cannot be easy to compile and certain balances must be achieved. Firstly, there is the balance of ‘too little’ or ‘too much’ in the 31 1 individual expanded abstracts which go to make up the book. Generally, these abstracts are of a size big enough to convey sophisticated messages while remaining short enough to hold the reader’s attention. Secondly, there is the balance of subjects to be discussed. The topics cover a wide spread of both arterial and venous disease, and the chapter on vascular trauma is particularly timely and

worthy of the attention of all in the vascular surgical field. Finally, there is the balance of laboratory versus clinical investigation and it is in this area that the true spirit of the book shines through. Although much of the volume concerns itself with clinical work, there is a satisfactory and satisfying number of laboratory based abstracts which carry clear implications for the practising doctor. Even the dullest and most steam-driven of clinicians should be able to grasp their importance.

In summary, this book has much to offer all who work with patients suffering from peripheral vascular disease. Too many books are described as being ‘essential reading’ but, for the vascular surgeon, this one really is!

J. Murie

Consultant Surgeon The Royal Infirmary Edinburgh EH3 9 Y W UK

Progress in Surgery. Volume 3 I , Taylor. 230 x 155 mm. Pp. 320. Illustrated. 1989. Edinburgh: Churchill Livingstone. €1 7.50.

It was a pleasure to read this third volume of Progress in Surgery which sets out to inform surgical trainees on a broad base and to keep established surgeons abreast of developments outside their special interest.

Immunology for the surgeon does require concentration and the chapters on anorectal problems in children and intracerebral haemorrhage are rather specialized but none of the chapters are lacklustre. I enjoyed the chapter on abdominal trauma and the rather unexpected account on venous access. The chapters on venous thrombosis and chemotherapy for colorectal cancer give a fair and up-to-date account which is just what is needed by the examination candidate.

The Editor is to be congratulated for producing a worthwhile and easily readable volume which is well-suited for the trainee and the consultant. At €17.50 it is modestly priced and should be available in every hospital library.

T. Bates

Consultant Surgeon William Harvey Hospital Ashford TN24 OLZ UK

Controversies in general surgery T. G . Allen-Mersh. 235 x I55 mm. Pp. 122. Not illustrated. 1989. London: Edward Arnold. E1O.OO. Surgeons are an argumentative bunch. Nothing could be more appealing than the prospect of a bare knuckle fight between the champions of hotly contested causes: ‘Surgery without prophylaxis against deep vein thrombosis is negligent’; ‘A 50 per cent ulcer relapse rate after one year of H, antagonists is preferable to a 10 per cent relapse after proximal vagotomy’; ‘Surgery has no place in the management of the symptoms of chronic pancreatitis’; and ‘Monitoring of serum CEA after colorectal cancer serves merely to forewarn the patient of his impending demise’ - to mention but four of the ten controversies in this 122 page book. The champions were surgeons in the Charing Cross and Westminster surgical training scheme (many of whom are now Consultants).

How is it that clever people can adhere to diametrically opposed opinions on these sorts of issue when they are presented with all the facts? The answers are: they didn’t read/assimilate/believe the facts; they have a different set of objectives to each other; and, they don’t actually believe what they have argued. As the various authors were allocated their topics and told what their stance was to be the inevitable conclusion in this case must be the third. Nevertheless, the book is enjoyable and contains many useful references. But what fun could have been had were real champions to have shed each other’s blood! And what an opportunity that would have been for the rest of us to see real bigotry at work!

R. K. S. Phillip

St Mark’s Hospital London ECI V 2PS UK

Br. J. Surg., Vol. 77, No. 2, February 1990 237