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“To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.”
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Endocrine surgery developed as a separate subspecialty of general surgery several decades ago. Endocrine surgery fellowships grew from about 10 in the world in the 1990s to more than 40 currently, with 22 to 25 within the United States. In addition to endocrine surgical fellowships, other disciplines—ENT/head and neck surgeons and surgical oncologists among them—have also created special training programs dedicated to caring for patients with endocrine surgical diseases of the thyroid, parathyroid, and adrenal glands and intestines and pancreas. Medical endocrinologists are now often closely associated with endocrine surgeons in the same practice setting to form single specialty groups. Major universities in the country have established endocrine surgery divisions and conduct weekly endocrine surgery tumor boards. Standard of care approach to the treatment of endocrine surgical disease has resulted in the development of the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP), designated by the American Board of Surgery as a primary nationally validated, risk-adjusted, outcomes-based program quality reporting system for all endocrine surgeons in the United States and all over the world, similar to NSQIP for general surgeons. Starting in the United States, CESQIP has now spread to other countries and continents, including Canada, Mexico, Europe, and Asia. Based on the CESQIP data, endocrine surgery reporting volume for the last 5 years has increased by 31% in the United States for thyroid, parathyroid, and adrenal procedures; in 2014, there were 1380 procedures reported in CESQIP; in 2015, 1753 procedures; in 2016, 1951 procedures; in 2017, 1995 procedures; and in 2018, 2011 procedures.
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The American Association of Endocrine Surgeons (AAES) counted about 300 members a decade ago and is now approaching almost 1000. In addition, other societies such as the European Society of Endocrine Surgeons (ESES), the International Association of Endocrine Surgeons (IAES), the Asian Association of Endocrine Surgeons (AAES), and other societies have grown over the past two decades, making the community of endocrine surgeons one of the fastest growing surgical subspecialties. The European Division of Endocrine Surgery (DES) established an Endocrine Surgery Board Examination and determined the curriculum for the Endocrine Surgery Board Examination and the Neck Endocrine Surgery Examination.
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This book is a ready source of information related to endocrine surgical diseases managed by endocrine surgeons, head and neck surgeons, surgical oncologists, and ENT surgeons. It includes endocrine surgical disorders of the thyroid, parathyroid, and adrenal glands, as well as neuroendocrine tumors of the intestines and pancreas. In addition, familial endocrine syndromes, including the multiple endocrine neoplasia syndromes, are covered. Epidemiology, pathophysiology, and pathology are discussed to the extent that they contribute to the book’s ultimate purpose, which is patient care guidance. It emphasizes quick recall of major diagnostic features and brief descriptions of the disease process, followed by approaches for definitive diagnosis and treatment. All treatment options are based on the current national and international guidelines. Emphasis is given to the multidisciplinary approach to all endocrine surgical conditions, which has been increasingly recognized as the standard of care. This book will help practitioners understand the best care options for endocrine surgical patients and point out how to utilize the multidisciplinary expertise available at their institutions. The book includes current references to the journal literature for the reader who wishes to pursue a specific area.
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We hope that this book will be the primary source and reference for daily practice, be utilized in preparation for Endocrine Surgery examinations, and elevate the level of expertise in Endocrine Surgery by augmenting the standard of training for current and future endocrine surgeons.
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Alexander Shifrin, MD
Thomas J. Fahey, III, MD