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Richard W Light (pp 413, $115.00) 2001. Philadelphia, PA: Lippincott Williams & Wilkins
The pleura is frequently involved in systemic disorders in addition to the diseases that originate in the lung or in the pleura itself. Pleural disease is therefore common and likely to become more common with the predicted increase in the incidence of mesothelioma. Common conditions are not always managed well, and pneumothorax and pleural effusions are two conditions where the expertise needed to manage them efficiently and effectively is often underestimated. A book that focuses on pleural disease and practical aspects of management is therefore welcome.
Pleural diseases, a single author book by Richard W Light, is now in its fourth edition. Its 400 pages provide a comprehensive review of all aspects of the pleura and pleural disease from the anatomy and physiology of the pleura to the range of disorders that cause pleural disease and their investigation and management. It is written by an enthusiast who draws widely from the literature on animals and man, in addition to his considerable clinical experience. The style of writing is conversational and easy to read, although it can be a little repetitive in places. Details of the individual studies are usually given, so the basis for the author’s conclusions is clear. The book provides a comprehensive and up to date reference source.
The chapters on common conditions such as pneumothorax flow well and are easy to follow. The pros and cons of various management options are debated with practical advice on management. The book is not designed to give didactic advice for the busy junior doctor at the sharp end of managing a patient with a pneumothorax or a pleural effusion, for example, but would be invaluable for drawing up guidelines for management of these conditions. The section on thoracoscopy and chest tubes discusses practical aspects of technique and potential complications, although the latter gives less emphasis to trocar tube thoracostomy than would be merited from practice in the United Kingdom.
The book is well presented, although figures and diagrams are somewhat sparse; the radiographs that are present are clear. I would have welcomed more figures, particularly diagrams to show the anatomy and relation of, for example, the thoracic duct and lymphatics. Better use could be made of line drawings—to explain the physiology of fluid collection in the pleural space and where to insert thoracostomy tubes, for example.
This book will clearly be essential for people with a clinical or research interest in pleural disease. It will also be a very valuable reference source for respiratory physicians and doctors in training.
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