Reconstructive Surgery of the Esophagus
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* Richard J. Bigsby

RECONSTRUCTIVE SURGERY OF THE ESOPHAGUS. Mark K. Ferguson. 344 pp. Illust. Futura Publishing, Co., Armonk, NY. 2001. US$105. ISBN 0-87993-494-8

The objective of this book is to look at the specific issues around the care and management of patients requiring esophageal reconstruction. It is the author’s intent to give a more thorough and detailed review of esophageal reconstructive surgery than is offered in the standard textbooks of esophageal surgery published to date. Recognition of difficulties that can occur when performing esophageal surgery highlights the need for such a book.

The introduction outlines historical aspects of esophageal surgery, an approach I find it helpful since it allows the reader to fully appreciate the innovations and changes that have occurred to help bring about a more practical and safe approach to esophageal surgery.

Given the complexities of reoperative esophageal surgery and the myriad of possibilities for replacing the esophagus, this textbook is mainly directed to practising thoracic surgeons and to general surgeons with a strong interest in esophageal disease. In this regard the book is highly readable and easy to follow. The text covers the techniques of esophageal reconstruction, including preservation techniques as well as the care and management of postoperative complications. It is a well laid-out book and can be read quickly. The author uses simple pictures to demonstrate operative techniques. For the most part, these adequately illustrate the point, although, sometimes they are a bit too simplistic. For a book that is trying to be a comprehensive reference text, more detailed illustration of operative techniques is required.

Although the author tries to be as scientific as possible in regard to recommendations, there are many instances in esophageal surgery where there are no large published series on which to base decision-making. Certainly, randomized clinical trials are a shortcoming in this discipline. The author has extensive experience and exposure to the works of other skilled surgeons, and his personal preference of operative technique and management would have been valuable.

One area of weakness is that of laparoscopic, thoracoscopic approaches to esophageal surgery. Some references are made to this evolving technique, but for the most part it is omitted from the book.

I enjoyed many aspects of this book, especially those involving benign esophageal disease. I think it should complement the library of any practising thoracic surgeon and serve as a useful reference text in the libraries of surgical training centres.