Frontiers in General Surgery

Recent developments have favourably and extensively altered general surgical practice. As editor I have happily been able to select certain topics of new and major interest for detailed discussion and have thus had the opportunity to collect these authoritative submissions within the covers of one text. The range of topics is broad. Endoscopy has changed the nature of both investigation and treatment of much gastrointestinal disease and the therapeutic uses of endoscopy continue to grow. That sophisticated new tool of the radiologist, computerized axial tomography, has revolu­ tionized the diagnosis of intra-abdominal disease, very often permitting precise localization of hitherto occult disease, and, as might be expect­ ed, it has become helpful in determining both the nature and extent of surgical and other therapy. Although an invasive procedure, intra­ abdominal angiography has similarly come of age as a means of localiz­ ing gastrointestinal haemorrhage and controlling such bleeding. Unfortunately, intra-abdominal malignancy continues to be a major source of concern to the general surgeon and the discovery that such tumours are associated with unusual markers, termed oncofetal anti­ gens, suggests that early diagnosis and early detection of recurrence may yet be feasible. Adjuvant or post-surgical therapy is an exciting de­ velopment in terms of prolonging the disease-free interval in women with breast cancer limited to regional lymph nodes. Equally efficacious therapy is not yet available for patients with gastrointestinal cancer, highlighting the need for more specific drugs and drug combinations.