慎重抉择手术
1.One should only advise surgery when there is a reasonable chance of success.To operate without having a chance means to prostitute the beautiful art and science of surgery.
—— Theodor Billroth, 1829——1894
【译文】只在有合理成功机会时，才建议手术。否则就是在卖弄兼具艺术和科学之美的外科手术。
2.Fit the operation to your patient, not your patient to the operation.
—— J.M.T.Finney
【译文】让手术适合于你的患者，而不是让患者来适合手术。
3.The right man in the right spot of the right time means life or death to the fortunate or poor patient.
—— Marian Littke
【译文】能否在正确的时候、正确的地点遇到正确的人将决定着一个患者是生是死，幸运还是可怜。
4.When you come to be an operator, you would do well to catechise yourself:does the operation bid fair to give relief? Is it to be of advantage, as promoting the improvement of the profession? Has self any thing to do with the matter -vanity of display, or personal distinction and consequent emolument?
—— Benjamin Bell, 1749——1806
【译文】在你做手术前，最好扪心自问：这个手术的性价比合适吗？是否有助于推进行业进步？我自己与这件事有利益关联吗——满足虚荣？或取得个人荣耀，并由此而获得报酬？
【点评】振耳发聩的良心叩问！
5.In deciding question, he should be unswerved by sympathy, unlured by gain,unterrified by censure.
—— J.Chalmers Da Costa, 1863——1933
【译文】（外科医生）做决策时，不应为同情心所左右、不应被利益所诱惑、不应为责难所吓倒。
【点评】让我们永远铭记这“三不”原则。
6.The basic guideline is "would you have this done to yourself, your wife,your child, your parent?"
—— Mark M.Ravitch, 1910——1989
【译文】（手术决定合适与否）一个最基本原则是：“若患者是你自己、你的妻子、孩子或你的父母，你会这样做吗？”
【点评】这一句比前一句的“三不”原则更管用，己所不欲，勿施于人。
7.The so-called surgeon who practices primarily for the fee, who advises operation without adequate study, who removes a normal organ without indication,who makes an emergency out of almost every case, has no problems or morals.
—— Edwin P.Lehman, 1888——1954
【译文】那种开业就是为了赚钱的所谓外科医生，没有充分研究就建议手术，没有任何指征就切除了一个正常的器官，几乎对每一个病例都做紧急处理，对他而言没有任何难题，也没有道德。
8.For elective and benign conditions always let the patient convince you that the planned operation is indicated.
—— Moshe Schein
【译文】面对择期和良性疾病，一定要让患者相信，这个择期手术是有指征的。
【点评】目前，针对良性疾患的择期手术似乎太多了一些。
9.Anything in surgery boils down to risk and benefit.
【译文】手术中所有的事情都可以归结为风险与收益。
10.Not to decide to operate at once is to decide not to operate at once.
—— Mark M.Ravitch
【译文】不马上去决定做手术就意味着决定不马上手术。
11.Overtreating and overdiagnosing are bad medicine.
—— Mark M.Ravitch
【译文】过度治疗与过度诊断都属不良医疗行为。
12.The lesser the indication, the greater the complication.(https://www.daowen.com)
【译文】手术指征越弱，术后并发症越多。
13.When doing everything according to indications, although things may not turn out agreeably to indication, we should not change to another while the original appearances remain.
—— By Hippocrates
【译文】（严格）按指征去做每一件事时，虽然事情的结果不一定符合指征的预期，但在初始表现没变化时，我们不应该改弦更张。
【点评】这就是我们对待“指征”应有的态度。
14．Anyone who believes that anything can be suited to everyone is a great fool, because medicine is practised not on mankind in general, but on every individual inparticular.
—— Henri de Mondeville
【译文】相信有一种方法能适合所有患者的人一定是个大傻瓜，因为医学实践不可能适用于整个人类，而只能针对某些特定的个体。
15.When there is multiplicity of operations for one condition, it proves that either none is effective, or all are effective
—— Mark M.Ravitch, 1910——1989
【译文】同一种病情有多个手术可选时，事实证明，要么没有一个有效，要么全部有效。
16．The decision for operation cannot be made by plebiscite.
—— Mark M.Ravitch, 1910——1989
【译文】不能靠公民投票做出手术决定。
【点评】手术不是民主政治。
17.I firmly believe that the best possible operation is not the same thing as the best operation possible.
—— Rodney Smith, 1914——1998
【译文】我坚信最好可能的手术和可能是最好的手术不是一码事。
18.The feasibility of an operation is not the best indication for its performance.
—— Henry Cohen, 1900——1977
【译文】手术的可行性并不是该手术最好的指征。
【点评】比可行性更为重要的是“必要性”和“安全性”。
19.Not all that is technically feasible is in the patient's best interest.
【译文】并非所有技术上可行的，都能让患者获得最大收益。
20.Don't confuse a good result with good practice.
—— Tom Curry
【译文】不要把好的结果和满意的过程混为一谈。
21.The Everest Syndrome: just because you can climb a mountain does not mean that you have to climb it; the same is true for any operation.
【译文】珠穆朗玛峰综合征：不要因为你能爬山就意味着你必须去爬，任何手术也都如此。
22.Are you sure that you are the best person for the job?
—— Francis D.Moore, 1913——2001
【译文】你确定你是这项工作的最佳人选吗？
【点评】所谓知己知彼方能百战不殆，知彼要的是智慧，知己要的是勇气。
23.Let someone else kill the patient-do not be a hero.
【译文】杀死患者的事还是让别人去做吧——别逞英雄。
【点评】要善于识别风险。