World journal of surgery
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Japanese students must pass very competitive entrance examinations to enter medical school after graduating from high school at the relatively young age of 18. There are currently 80 medical schools in Japan, with approximately 7700 students graduating annually. Since 2004, after passing the National Medical Board Examination, all medical graduates are required to complete a 2-year period of clinical training to become medical practitioners. ⋯ General surgery board certification is a prerequisite for subspecialty board certification. Notwithstanding these revisions, the number of surgery candidates is steadily declining because work conditions in the surgical profession are viewed as unfavorable. To regain some level of the previous attractiveness and glory of this specialty, surgeons need to receive significant incentives that counteract some of the downsides of the life of a surgeon.
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World journal of surgery · Oct 2008
Evaluation of the outcome of complete sinus excision with reconstruction of the umbilicus in patients with umbilical pilonidal sinus.
Umbilical pilonidal sinus is a cause of umbilical discharge. In this study, the outcome of complete excision of the umbilical sinus with umbilical reconstruction is considered. Adult patients with umbilical pilonidal sinus who had not undergone any previous surgeries were operated on using a technique that involves complete excision of the sinus after eversion of the umbilicus followed by reconstruction of the umbilicus. ⋯ Only four patients had wound drainage after operation, and all required drainage of the wound. No recurrence was observed during the follow-up period, and all patients were satisfied with the appearance of their umbilicus. The technique of complete sinus excision and umbilical reconstruction is an effective and acceptable method for treating umbilical pilonidal sinus and may be recommended for primary treatment of this disease.
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Surgical education for medical students in Australia and New Zealand is provided by 19 universities in Australia and 2 in New Zealand. One surgical college is responsible for managing the education, training, assessment, and professional development programs for surgeons throughout both countries. The specialist surgical associations and societies act as agents of the college in the delivery of these programs, the extent of which varies among specialties. ⋯ Trainees' progress is assessed by workplace-based assessment and formal examinations, including an exit examination. The sustained production of sufficient competent surgeons to meet societal needs encompasses many challenges including the recruitment of appropriate graduates and the availability of adequate educational and clinical resources to train them. Competence-based training is an attractive educational philosophy, but its implementation has brought its own set of issues, many of which have yet to be resolved.
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World journal of surgery · Oct 2008
Review Randomized Controlled Trial Multicenter StudyWater-soluble contrast medium (gastrografin) value in adhesive small intestine obstruction (ASIO): a prospective, randomized, controlled, clinical trial.
Patients with adhesive small intestine obstruction (ASIO) are difficult to evaluate and to manage and their treatment is still controversial. The diagnostic and therapeutic role of water-soluble contrast medium (Gastrografin) in ASIO is still debated. This study was designed to determine the therapeutic role of Gastrografin in patients with ASIO. ⋯ Data showed that the use of Gastrografin in ASIO is safe and reduces the operative rate and the time to resolution of obstruction, as well as the hospital stay.
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World journal of surgery · Oct 2008
Multicenter Study Comparative StudyCurrent status of surgical management of acute cholecystitis in the United States.
We attempted to determine population-based outcomes of laparoscopic (LC) and open cholecystectomy (OC) for acute cholecystitis (AC). ⋯ Most patients in the 21st century with AC undergo LC with a low conversion rate and low morbidity. In the general population with acute cholecystitis, LC results in lower morbidity and mortality rates than OC even in the setting of open conversion.