Therapeutic gastrointestinal endoscopy

Therapeutic gastrointestinal endoscopy

GASTROENTEROLOGY 1986;90:502-6 BOOK REVIEWS Armand Littman, M.D. Book Review Editor Veterans Administration Hines, Illinois 60141 Hospital Therap...

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Armand Littman, M.D. Book Review Editor Veterans Administration Hines, Illinois 60141


Therapeutic Gastrointestinal Endoscopy. Edited by S. E. Silvis. 321 pp., $78.50. Igaku-Shoin, New York, New York, 1985. The editor of this well-constructed, practical text believes that therapeutic endoscopy is the wave of the future. For today’s practicing gastrointestinal endoscopist the future is now. This volume is a long-needed and welcome addition to any endoscopic library. All of the common therapeutic procedures are reviewed in detail with an emphasis on techniques. The chapters on esophageal dilatation and removal of foreign bodies provide new approaches and describe refinements of methods. The treatment of gastrointestinal bleeding is covered in clear and well-illustrated sections on electrocoagulation, laser and topical treatment, and sclerotherapy. Colonoscopic polypectomy is presented as both a review of electrosurgical techniques for all types of polyps as well as a valuable prospectus for their clinical management. The section on gastric polypectomy should clarify the controversial aspects of indications and techniques. The two chapters that deal with therapy of the biliary system contain clearly illustrated descriptions of the very difficult procedures of sphincterotomy and stent decompression. The fine details of methods and discussions of indications and risks are of value to all endoscopists performing these therapies, regardless of their personal expertise. Up-todate descriptions of laser therapy for GI neoplasms, placement of intestinal tubes, and treatment of vascular abnormalities complete these reviews. A generous bibliography follows each section and numerous clear, color endoscopic photographs serve as a supplemental atlas. Though this therapeutic text was prepared for the experienced diagnostic endoscopist, it is valuable for anyone involved in gastrointestinal endoscopy today. MELVIN SCHAPIRO,M.D. Encino, California

Gastrointestinal Endoscopy for Surgeons. Edited by R. K. Pearl. 190 pp., $29.95. Little, Brown & Company, Boston, Massachusetts and Toronto, Canada, 1985.

Surgical Endoscopy. By T. L. Dent, W. E. Strodel, and J. G. Turcotte. 536 pp., $59.95. Year Book Medical Publishers, Inc., Chicago, Illinois, 1985. Clearly, Gastrointestinal Endoscopy for Surgeons is not the same as Surgical Endoscopy. The first, a “step-by-step guide to various endoscopic procedures for the novice,” is written in cookbook style that teaches systematically, with line drawings, all the diagnostic and operative GI endoscopic procedures. The authors compress a good deal into simple, brief tables or short paragraphs, providing a check-

list of indications, preparations, techniques, findings, hazards, and complications for each technique or organ. The range of techniques covered is comprehensive and includes principles of electrosurgery, upper GI endoscopy, endoscopic Congo red test for completeness of vagotomy, sclerotherapy of varices, choledochoscopy, ERCP, laparoscopy, colonoscopy, flexible sigmoidoscopy, rigid proctosigmoidoscopy, and anoscopy, including banding of hemorrhoids. The drawings, which occupy about half the book, are good, though many will be recognizable only to those already familiar with endoscopy. It is not likely that the 22 drawings comprising the “atlas of upper G-I endoscopic findings” would be enough to launch the novice into a career. The authors draw on the endoscopic teaching at Cook County Hospital and have produced what might be a useful supplement to the teaching of their own trainees. However, the book would be marginally useful to an untrained novice, especially to one who would hazard to become self-taught through this medium. The second book is a compilation of presentations by surgeons practicing endoscopy of various kinds at a symposium held in Ann Arbor in May 1985. The selection of topics is unsystematic, and the report provides only a survey of how each surgeon had applied endoscopy to his own area of interest. The book does not appear to have had much editing. Even good symposia seldom translate into good books without intensive editing. It is not clear to whom this compilation might be useful, for it is neither a manual nor a critical systematic review that would allow any endoscopist to acquire a comprehensive view of endoscopy. The conference is presented in 33 papers organized into four parts-“Gastrointestinal tract,” “Biliary tract,” “Other systems (nasopharynx, lungs, joints, urologic, laparoscopic),” and “Teaching and practice.” There is no attempt to carry a thread or concept through the various presentations. Some present “how to” information [e.g., colonoscopic polypectomy [chapter 15)]; others present results of work done in a certain field [e.g., injection sclerotherapy of varices in Cape Town using the rigid esophagoscope (chapter 4)], surveys of an area of endoscopy [e.g., flexible fiberoptic endoscopy in infants and children [chapter lo)], descriptive testimonials [e.g., endoscopy in the community setting (chapter 32)], and wordy reviews that do little to instruct [e.g., upper GI hemorrhage [chapter l)]. The illustrations are poor. Many would have been better as sharp line drawings or should have been left out altogether. The quality and selection of the 37 color plates in the Appendix are no better. One might not argue with the senior editor that endoscopy is basically “an internal physical examination that should be available to all surgeons who see and treat abnormalities of the GI tract” (p. 488), except to ask whether alI surgeons require endoscopic training (p. 489).