The Oxford Textbook of Surgery aims to present a picture of surgery in its totality. To achieve this it has brought together the experience of surgical practice from two major clinical schools on opposite sides of the Atlantic, namely the Oxford University Clinical School and the Massachusetts General Hospital Clinical School of the Harvard Medical School, for most of the contributors are on the staff of one or the other or have worked in one or other institution in the past. In some instances former visiting Professors have been brought into play but the vast majority of contributors can claim some allegiance to one or other institution. We have found, not surprisingly perhaps, that, with one or two notable exceptions, such as, for example, in the approach to cancer of the prostate, the practice of surgery in the United Kingdom and the United States does not differ remarkably. Each subject has been covered by an expert in the field writing from his or her own wisdom and experience, but remembereing past needs and difficulties during training days.

In this book we have approached surgery from a practical point of view and have attempted to cover most aspects of general surgery (an entity less easily defined nowadays) as well as giving an overview of the various specialist branches of surgery ranging from orthopaedics and neurosurgery through cardiothoracic surgery to plastic surgery. To achieve detailed coverage of every aspect of surgery in one textbook is obviously impossible, but our aims were to produce a book which could be used as a source of reference by general surgeons, either trained or in training, both in the Western world and in developing countries, and equally to provide a ready source of reference for surgeons in specialist branches of surgery, such as neurosurgery and orthopaedic surgery. We hope that with this approach general surgeons will not only get a feeling for current practice in their own areas of interest but will also be able to obtain sufficient information about problems presenting in their patients that involve, or might involve, another speciality. Similarly the specialist surgeon can also find sufficient material in the Textbook concerning some problem in general surgery or another specialist branch of surgery to be able to reassure a patient or to use for teaching purposes. We feel strongly that there is still a major need for a comprehensive textbook of surgery in this age of increasing specialization. Our approach should also prove invaluable to the medical undergraduate as well as to the surgeon practising in developing countries, where the general surgeon remains truly a generalist.

We have endeavoured to make the text become alive and attractive by the widespread use of colour for illustrations and tables, a major innovation for a textbook of surgery. This aim has certainly been achieved in our opinion by our publishers, Oxford University Press. Our thanks are due to their staff.

We are grateful to all our contributors who have been most patient during the gestation of the book. We especially wish to thank Mr Steve Westaby and Dr John Baldwin who organized the cardiac surgery section, Mr Chris Adams who planned the neurosurgery section, Dr Steve Dretler for the urology section, and Dr Michael Ehrlich of Brown University (formerly MGH) who, with his department, dealt with the whole of the orthopaedic section.

We hope that you will find this book an attractive and readily approachable treatise on surgery in its entirety, whether you be practising, training, or studying in the Western world or indeed in a developing country with limited resources.

Peter J. Morris

Oxford

Ronald A. Malt

Boston

Dose schedules are being continually revised and new side-effects recognized. Oxford University press makes no representation, express or implied, that the drug dosages in this book are correct. For these reasons the reader is strongly urged to consult the drug company's printed instructions before administering any of the drugs recommended in this book.