Endocrine surgery.

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
American journal of surgery (Impact Factor: 2.36). 09/2011; 202(3):369-71. DOI: 10.1016/j.amjsurg.2011.06.004
Source: PubMed

ABSTRACT The increasing complexity in the management of surgical disorders of the thyroid, parathyroid, adrenal glands, and neuroendocrine pancreas tumors have led to the emergence of endocrine surgery as a surgical subspecialty. Studies showing the relationship between hospital/surgeon volume and patient outcomes highlight the importance of advanced postgraduate training in this field.

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    ABSTRACT: Surgeon experience has been demonstrated to result in better outcomes after a variety of advanced operations. Less information is available regarding adrenal surgery. We compared the outcomes after adrenalectomy for a variety of indications and determined the effect of surgeon's case volume. Cross-sectional analysis was performed using ICD-9 procedure codes included in the Nationwide Inpatient Sample from 2003 to 2009 to identify all adult patients who underwent unilateral or bilateral adrenalectomy for benign or malignant conditions. Logistic regression was used to test for interaction between surgeon case volume (low = 1, intermediate = 2-5, and high = >5 adrenalectomies per year), diagnosis, type of operation performed, and risk of complications. A total of 7,829 adrenalectomies were included. Risk of complications after bilateral adrenalectomy was 23.4 % compared to 15.0 % for unilateral adrenalectomy (odds ratio 2.165, 95 % confidence interval 1.335, 3.512). Malignancy was associated with higher risk of complication (23.1 %) than benign disease (13.2 %) (odds ratio 1.685, 95 % confidence interval 1.371, 2.072). Complication rates for low- and intermediate-volume surgeons were 18.8 and 14.6 %, respectively, and both were significantly higher than complications by high-volume surgeons (11.6 %, p < 0.05). Length of stay and charges were both significantly less for high-volume surgeons compared to lower-volume groups (p < 0.05). Low surgeon case volumes and adrenal surgery for malignant or bilateral disease are associated with increased risk of postoperative complications. Length of stay and charges were significantly less when high-volume surgeons perform adrenal surgery.
    Annals of Surgical Oncology 05/2014; 22(1). DOI:10.1245/s10434-014-3750-2 · 3.94 Impact Factor
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    ABSTRACT: Background The American Association of Endocrine Surgeons (AAES) initiated a fellowship match in 2007. The profile of applicants who successfully match into an endocrine surgery (ES) fellowship has not previously been characterized. Methods An IRB-approved, web-based, survey was distributed to recent and current ES fellows. Results The survey response rate was 62% (56/90). The overall mean age was 33 years old (SD ± 3), 54% were female and 37% self-identified as non-white. Only 5% entered their surgical training with the aim of specializing in ES. During residency, respondents were exposed to high volumes of index ES cases. Sixty-two percent had dedicated research time. At the time of fellowship application, the median number of publications was 5 (range, 0-25), and 30% of respondents had additional advanced degrees. Conclusion Entering ES fellows have diverse backgrounds, with strong academic credentials. These data help inform the career mentoring of aspiring ES applicants.
    The American Journal of Surgery 10/2014; 208(4). DOI:10.1016/j.amjsurg.2014.03.013 · 2.41 Impact Factor
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    ABSTRACT: General surgery residency training can lead to a rewarding career in general surgery and serve as the foundation for careers in several surgical subspecialties. It offers broad-based training with exposure to the cognitive and technical aspects of several surgical specialties and prepares graduating residents for a wide range of career paths. This career development resource discusses the training aspects of general surgery.
    American journal of surgery 11/2013; 206(5):719-23. DOI:10.1016/j.amjsurg.2013.07.010 · 2.36 Impact Factor


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