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It is a well known fact that the surgical treatment of exophthalmic goiter in centers highly specialized in thyroid surgery may be carried out with a practically negligible mortality. In spite of many serious complications of this disease (hypertension, arteriosclerosis, diabetes and auricular fibrillation) the mortality is much lower than in chronic appendicitis or inguinal hernia when the latter diseases are associated with cardiac or other complications. This low mortality, however, is usually not maintained in general hospitals, where mortality figures are often from five to ten times higher than in special thyroid clinics. These clinics with a few thousand goiter operations a year have naturally developed an almost perfect organization both medically and surgically. It has been claimed that a similar organization cannot be maintained in a general hospital. Undoubtedly this statement is correct unless an organization within a general hospital is created for the proper management of this
LEWISOHN R, OPPENHEIMER BS, SILVER S. THE MANAGEMENT OF EXOPHTHALMIC GOITER IN A GENERAL HOSPITAL. JAMA. 1939;113(17):1527–1531. doi:10.1001/jama.1939.02800420001001
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