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Khartoum, Sudan
Abstract
By John F. Beamis Jr, Praveen N. Mathur, and Atul C. Mehta, eds. New York, NY: Marcel Dekker, 2004: 689 pp; $199.95
Until recently, interventional pulmonary medicine was limited to invasive bronchoscopic procedures including foreign-body removal, debulking of endobronchial tumors, or insertion of stents for the palliation of lung cancer. Most of these procedures were performed under general anesthesia by thoracic surgeons using a rigid bronchoscope, and as a result only a few pulmonary physicians developed an interest in interventional techniques. In recent years, however, there have been advances in many areas of pulmonology, including interventional techniques, and many pulmonary physicians train in, and practice, interventional pulmonology. Significantly, these new interventions have been shown to improve lung function and quality of life in patients with serious pulmonary conditions that have hitherto been considered irremediable.
Interventional Pulmonary Medicine presents an extensive overview of the techniques encompassed by interventional pulmonary medicine. The editors are unquestionably leaders in this burgeoning field, and have drawn on other experts from the Americas, Europe, Asia, and Africa to compile the 30 chapters in this valuable text. The book begins with an historical review of rigid and flexible bronchoscopy, followed by chapters that discuss 27 diagnostic and therapeutic interventional procedures, including 18 bronchoscopic and 4 thoracoscopic procedures. Additional chapters cover whole-lung lavage, percutaneous tracheostomy, and other specialized applications. The organization of the chapters is consistent, putting each intervention into perspective as well as providing the detailed overview that one would expect, but not including a step-by-step "how-to-do-it" approach. Nevertheless, the techniques are explained in broad terms, and the reader is referred to appropriate sources for the details. In this sense, Interventional Pulmonary Medicine serves as a reference book rather than a handbook of pulmonary interventions.
Each chapter of the text can be read independently and presents a state-of-the-art review of the subject. The different chapters are extensively referenced and illustrated with photographs and diagrams. I would like to have seen the photographs reproduced in color rather than black and white, which I think would have served the purpose of instructing the reader more efficiently. In fact, improvements in the reproduction of photographs in a few chapters would have been desirable.
The closing chapters address the following two important issues: clinical outcomes and training. The practice of interventional pulmonary medicine involves invasive procedures that are usually performed in patients with serious pulmonary disorders and is, consequently, not without risks. It follows that physicians who practice interventional pulmonology should be highly trained, and a full chapter is devoted to a detailed discussion of the requirements for education in this field, including levels of competence that should be reached before a trainee is allowed to practice. The text then concludes with an informative procedural algorithm for common clinical situations in which interventions may be contemplated.
Overall, this is a comprehensive, extensively referenced, and well-written book. It is a textbook rather than a manual of interventional pulmonology and would most likely appeal to a wide spectrum of pulmonologists, but particularly to those with a special interest in interventional pulmonology.
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