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Access to the electronic materials is limited to the first individual who redeems the PIN, located on the inside cover of this book, at expertconsult.inkling.com andmay not be transferred toanotherparty by resale, lending, orothermeans. 2020_PC_IE 21 ST S A B I S T O N EDITION TEXTBOOK of SURGERY The BIOLOGICAL BASIS of MODERN SURGICAL PRACTICE COURTNEY M. TOWNSEND, JR., MD B. MARK EVERS, MD Professor Professor and Vice-Chair for Research Robertson-Poth Distinguished Chair in General Surgery Department of Surgery Department of Surgery Director, Lucille P. Markey Cancer Center The University of Texas Medical Branch Markey Cancer Foundation Endowed Chair Galveston, Texas Physician-in-Chief, Oncology Service Line UK Healthcare University of Kentucky Lexington, Kentucky R. DANIEL BEAUCHAMP, MD J.C. Foshee Distinguished Professor of Surgery KENNETH L. MATTOX, MD Professor of Cell and Developmental Biology Deputy Director, Vanderbilt-Ingram Cancer Center Distinguished Service Professor Vice President Cancer Center Network Affairs Michael E. DeBakey Department of Surgery Vanderbilt University Medical Center Baylor College of Medicine Nashville, Tennessee Chief of Staff and Surgeon-in-Chief Ben Taub General Hospital Houston, Texas Elsevier 3251 Riverport Lane St. Louis, Missouri 63043 SABISTON: TEXTBOOK OF SURGERY: THE BIOLOGICAL BASIS OF Standard Edition: 978-0-323-64062-6 MODERN SURGICAL PRACTICE, TWENTY FIRST EDITION International Edition: 978-0-323-64063-3 Copyright © 2022, Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. 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This page intentionally left blank C O N T R I B U T O R S Corinne M. Aberle, MD Kristen A. Aliano, MD Assistant Professor Plastic Surgeon Division of Cardiothoracic Surgery Private Practice University of Miami McGuiness Dermatology and Aesthetics Miami, Florida Dallas-Fort Worth, Texas United States United States Naim Abu-Freha, MD, MHA Ronald D. Alvarez, MD, MBA Department of Gastroenterology and Professor and Chair Hepatology Obstetrics and Gynecology Soroka University Medical Center Vanderbilt University Medical Center Faculty of Health Sciences Nashville, Tennessee Ben-Gurion University of the Negev United States Director, Department of Gastroenterology Assuta Medical Center—Beer Sheva Vamsi Aribindi, MD Beer Sheva, Israel Surgical Resident Department of Surgery Andrew B. Adams, MD, PhD Baylor College of Medicine Associate Professor Houston, Texas Surgery United States Emory University School of Medicine Atlanta, Georgia Amanda K. Arrington, MD United States Associate Professor Department of Surgery Reid B. Adams, MD University of Arizona Chair, Department of Surgery Tucson, Arizona Claude A. Jessup Professor of Surgery United States University of Virginia Charlottesville, Virginia Omar Atassi, MD United States Assistant Professor of Orthopedic Trauma Ben Taub General Hospital Nikhil Agrawal, MD Department of Orthopedic Surgery Resident Baylor College of Medicine Surgery Houston, Texas Baylor College of Medicine United States Houston, Texas United States I. Raul Badell, MD Assistant Professor Vanita Ahuja, MPH, MBA, MD Surgery Associate Professor of Surgery Emory University School of Medicine Yale University School of Medicine Atlanta, Georgia New Haven, Connecticut United States United States Chief, General Surgery Faisel G. Bakaeen, MD VA Connecticut HealthCare System Professor West Haven, Connecticut Thoracic and Cardiovascular Surgery United States Cleveland Clinic Cleveland, Ohio Sophoclis Alexopoulos, MD United States Associate Professor Section of Surgical Sciences Juan Camilo Barreto, MD Chief, Division of Liver Transplantation and Hepatobiliary Assistant Professor of Surgery Surgery Division of Surgical Oncology Vanderbilt University Medical Center University of Arkansas for Medical Sciences Nashville, Tennessee Little Rock, Arkansas United States United States v vi CONTRIBUTORS R. Daniel Beauchamp, MD, FACS Benjamin S. Brooke, MD, PhD J.C. Foshee Distinguished Professor of Surgery Associate Professor of Surgery & Population Health Sciences Professor of Cell and Developmental Biology Chief, Division of Vascular Surgery Deputy Director, Vanderbilt-Ingram Cancer Center Section Chief, Health Services Research Vice President Cancer Center Network Affairs Department of Surgery Vanderbilt University Medical Center University of Utah Nashville, Tennessee Salt Lake City, Utah United States United States Yolanda Becker, MD, FACS, FAST Carlos V.R. Brown, MD, FACS Professor of Surgery Chief, Division of Acute Care Surgery Director of Kidney and Pancreas Transplant Department of Surgery University of Chicago Dell Medical School, University of Texas at Austin Chicago, Illinois Austin, Texas United States United States Elizabeth E. Blears, MS Alfredo Maximiliano Carbonell, DO General Surgery Resident Vice Chairman of Academic Affairs Allegheny Health Network Department of Surgery Pittsburgh, Pennsylvania Prisma Health -Upstate United States Professor of Surgery University of South Carolina School of Medicine - Greenville Iuliana Bobanga, MD Greenville, South Carolina Case Western Reserve University School of Medicine United States Clinical Assistant Professor Department of Surgery Samuel P. Carmichael II, MD MS University Hospitals Cleveland Medical Center Assistant Professor of Surgery Cleveland, Ohio Department of Surgery United States Wake Forest University School of Medicine Wake Forest Baptist Health Morgan Bonds, MD Winston-Salem, North Carolina Fellow United States General, Vascular, and Thoracic Surgery Virginia Mason Medical Center Joshua S. Carson, MD Seattle, Washington Assistant Professor of Surgery United States Department of Surgery University of Florida College of Medicine Mimi R. Borrelli, MBBS, MSc Gainseville, Florida Research Fellow United States Surgery Stanford University Howard C. Champion, MD, FACS Palo Alto, California Professor of Surgery United States F. Edward Hébert School of Medicine Resident Uniformed Service University of the Health Sciences Department of Plastic Surgery Bethesda, Maryland Brown University United States Providence, Rhode Island United States Kevin J. Chiang, BA, MD Acute Care Surgery Fellow Stefanos Boukovalas, MD Division of Trauma, Emergency Surgery, and Surgical Microvascular Reconstructive Fellow Critical Care Department of Plastic Surgery Massachusetts General Hospital The University of Texas MD Anderson Cancer Center Harvard Medical School Houston, Texas Cambridge, Massachusetts United States United States CONTRIBUTORS vii Dai H. Chung, MD, FACS Rajeev Dhupar, MD, MBA, FACS Professor and Strauss Chair in Pediatric Surgery Chief of Thoracic Surgery UT Southwestern Medical Center Surgical Services Division Dallas, Texas VA Pittsburgh Healthcare System United States Assistant Professor Cardiothoracic Surgery Michael Coburn, MD University of Pittsburgh School of Medicine Professor and Chairman Pittsburgh, Pennsylvania Scott Department of Urology United States Baylor College of Medicine Houston, Texas Jose J. Diaz, MD, CNS, FACS, FCCM United States Professor of Surgery Vice Chair Quality & Safety Eric L. Cole, MD Chief, Division of Acute Care Surgery Assistant Professor Program Director Acute Care Surgery Division of Plastic Surgery Fellowship Program in Trauma The University of Texas Medical Branch R. Adams Cowley Shock Trauma Center Galveston, Texas University of Maryland School of Medicine United States Baltimore, Maryland United States Carlo M. Contreras, MD Associate Professor Sharmila Dissanaike, MD, FACS, FCCM Surgery Peter C. Canizaro Chair and Professor The Ohio State University Department of Surgery Columbus, Ohio Texas Tech University Health Sciences Center United States Lubbock, Texas United States Robert N. Cooney, MD, FACS, FCCM Professor and Chairman Roger R. Dmochowski, MD, MMHC Surgery Professor SUNY Upstate Medical University Department of Urologic Surgery Syracuse, New York Vice Chair for Faculty Affairs and Professionalism United States Section of Surgical Sciences Associate Surgeon-in-Chief Jack Dawson, MD Vanderbilt University Medical Center Associate Professor of Orthopedic Trauma Nashville, Tennessee Chief of Orthopedic Surgery United States Ben Taub General Hospital Department of Orthopedic Surgery Vikas Dudeja, MBBS, FACS Baylor College of Medicine Selwyn M. Vickers Endowed Scholar Houston, Texas Director and Associate Professor United States Division of Surgical Oncology University of Alabama Abe DeAnda Jr., MD Department of Surgery Professor and Chief Birmingham, Alabama Division of Cardiovascular and Thoracic Surgery United States University of Texas Medical Branch Galveston, Texas Quan-Yang Duh, MD United States Professor, Chief Section of Endocrine Surgery Surgery Bradley M. Dennis, MD, FACS University of California, San Francisco Associate Professor of Surgery Attending Surgeon Division of Trauma and Surgical Critical Care Surgery Vanderbilt University Medical Center Veterans Affairs Medical Center Nashville, Tennessee San Francisco, California United States United States