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Edited by P Puri. London: Arnold, 2003, £195, pp 976. ISBN 034076144X
Neonatologists are not always directly involved in the intensive care of neonates as surgical patients. In my own case this has led to a slightly blinkered approach. I am very familiar with perinatal stabilisation of problems such as gastroschisis, with the intensive care of infants with diaphragmatic hernias, and with the referral of infants with less acute problems. However, perioperative management, particularly of uncomplicated cases, and the mysteries of operative techniques have been beyond my reach. A book, with neonatologists within its scope, ideally with strong emphasis on presentation, embryology, and associations as well as describing surgical options, would plug a significant gap in my knowledge.
With 97 chapters, typically under 10 pages each, this book certainly has breadth of coverage. Chapters typically deal with a problem such as chylothorax, subglottic stenosis, or necrotising enterocolitis and describe the authors’ perspective on management. There are numerous photographs, radiographs, and drawings in nice balance with the text. Fascinating drawings, intended to complement the “comprehensive description of operative techniques” left me wondering that such complicated operations could be so simply described. The authors are drawn from all over the world, but the book’s style remains uniformly European.
The book begins with a series of chapters dedicated to general and theoretical aspects of the care of these high risk infants. These areas of overlap with standard neonatal texts are very variable and, from my perspective, also very interesting. Some could have been more up to date. It was also interesting for example to see a chapter on neonatal transport written by two paediatric surgeons rather than by neonatologists.
Some overlap is inevitable in a book like this. However, I would have preferred, for example, that either there was more embryology in each surgical chapter or a more comprehensive introductory chapter. A well written chapter on ethics, from a purely North American perspective, occupies eight pages, which is also the space given to parenteral nutrition. The five sides dedicated to respiratory management of the newborn emphasised to me the potential rewards to be reaped from closer integration of training and practice in neonatology and newborn surgery.
The chapters on surgical problems are the book’s strongest area. We have found the book valuable in furthering our understanding of the problems we see on a day to day basis. Many of the lesions in question are relatively rare, which makes the superspecialist multiauthor approach most valuable. The inclusion of problems sometimes dealt with by neurosurgeons and plastic surgery specialists makes this an especially attractive volume. Only the occasional chapter seemed to focus too heavily on the authors’ own experience without consideration for the variety of techniques in use.
I’m glad to say that this book is the one to plug the gaps in my knowledge. I would therefore recommend this book to fellow paediatricians, much as I would encourage surgeons and neonatologists to further develop collaboration in practice and in training.