Journal of the American College of Surgeons
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Meta Analysis Comparative Study
Laparoscopic herniorrhaphy: beyond the learning curve.
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Some patients with Graves' disease who select surgical therapy so they can discontinue antithyroid medication require lifelong levo-thyroxin (l-T4) replacement therapy because of irreversible postoperative hypothyroidism. The aim of this study was to enable the replacement of absent thyroid hormone through autotransplanted thyroid tissue that had been cryopreserved since the initial thyroid operation, and to release these patients from lifelong l-T4 administration. ⋯ Despite a few remaining uncertainties that must be resolved before this procedure is optimized, autotransplantation of cryopreserved thyroid tissue promises to be a useful therapeutic procedure for treating permanent postoperative hypothyroidism in patients with Graves' disease.
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Surgical subspecialization has croded the traditional domain of the general surgeon. The purpose of this study was to assess the volume and distribution of colon and rectal cases performed by general surgeons. ⋯ General surgeons perform a substantial number of colon resections and relatively few anorectal cases. It is unclear whether this is an issue of anorectal training in general surgery programs or referral patterns.
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Approximately 1,000 individuals complete graduate surgical education in general surgery each year. Their subsequent career pathways have not been described but may have relevance to the supply of general surgeons available to provide a broad range of surgical care to the population of the USA. ⋯ Most surgeons who completed a general surgery residency program from 1983 to 1990 are certified and presumably have met high standards for knowledge and experience. More than half of the graduates specialize further.