About This Journal FREE

To promote the art and science of surgery by publishing relevant peer-reviewed clinical and basic science information to assist the surgeon in optimizing patient care. The Archives of Surgery will also serve as a forum for the discussion of issues that involve ethics, teaching, surgical history, and socioeconomic concerns.

Approved by the Editorial Board, Archives of Surgery, July 19, 1996.

Editor: Claude H. Organ, Jr, MD University of California–San Francisco, East Bay 1411 E 31st St Oakland, CA 94602 archivesofsurgery@earthlink.net

Associate Editor, CME Section Editor: Gerald W. Peskin, MD Oakland, Calif

Section Editor, Operative Techniques: Jack Pickleman, MD Chicago, Ill

Web Editor: Grace S. Rozycki, MD Atlanta, Ga

Editorial Assistant: Margaret M. Kosiba Emeryville, Calif Phone: (510) 437-4940 Fax: (510) 534-5639 archivesofsurgery@earthlink.net

Timothy R. Billiar, MD, Pittsburgh, Pa Richard J. Bold, MD, Sacramento, Calif Jo Buyske, MD, Philadelphia, Pa Laurence Y. Cheung, MD, Kansas City, Kan Karen E. Deveney, MD, Portland, Ore Susan Galandiuk, MD, Louisville,Ky Clive S. Grant, MD, Rochester, Minn Alden H. Harken, MD, Denver, Colo J. Michael Henderson, MD, Cleveland, Ohio Eddie L. Hoover, MD, Buffalo, NY Joseph A. Ignatius, MD, Santa Barbara, Calif Danny O. Jacobs, MD, MPH, Omaha, Neb Stephen F. Lowry, MD, New Brunswick, NJ Ronald V. Maier, MD, Seattle, Wash David S. Mulder, MD, Montreal, Quebec Thomas A. Mustoe, MD, Chicago, Ill J. Patrick O'Leary, MD, New Orleans, La Mark L. Silen, MD, MBA, Portland, Ore Bruce E. Stabile, MD, Torrance, Calif Robert W. Thompson, MD, St Louis, Mo Steven D. Wexner, MD, Fort Lauderdale, Fla Michael E. Zenilman, MD, Brooklyn, NY

Licinio Angelini, MD, Rome, Italy Leigh W. Delbridge, MD, Sydney, NSW, Australia S. T. Fan, MB, BS, MS, Hong Kong, China Ch. Herfarth, MD, Heidelberg, Germany Kazutomo Inoue, MD, Kyoto, Japan Jin-Pok Kim, MD, Seoul, Korea Raj Mohan Nambiar, MBBS, Singapore Hector Orozco, MD, Mexico City, Mexico Bernard F. Ribeiro, MB, BS, FRCS, London, England Manuel Trias, MD, PhD, Barcelona, Spain

Dean Lewis, MD 1920-1940 Waltman Walters, MD 1941-1942; 1946-1961 Lester Dragstedt, MD 1943-1945 J. Garrett Allen, MD 1962-1969 Richard Warren, MD 1970-1976 Arthur Baue, MD 1977-1988

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Catherine D. DeAngelis, MD, MPH Editor in Chief, Scientific Publications & Multimedia Applications Cheryl Iverson Managing Editor

Department Director: Paula Glitman Copyediting Manager: Brenda Gregoline Freelance Copyediting Manager: Diane L. Cannon Freelance Copyediting Coordinators: Lauren B. Fischer, Connie Manno Editorial Systems Managers: Paul Frank, Monica Mungle Systems Programmer/Internet Specialist: J. D. Neff Senior Copy Editor: Vickey Golden Copy Editors: Juana N. Llorens, Rachel Novickas, Cheryl L. Tobey, Rachel Bodzin Young Editorial Assistant: Wanda Hill

Assistant to the Editor: Helga Fritz

Director: Margaret Winker, MD Electronic Media Department Director: Michelle Kurzynski Associate Web Editors: Katherine Behar, Erin M. Giannini Web Office Manager: Marla A. Hall

Group Publisher: Nawin Gupta, PhD VP Office Staff: James Clinton, Geoffrey Flick, Terri Hanley, Maureen Archey, Anna Goins International Business and Development: William Fox (director), Norman Frankel, PhD, Rhonda Bailey, Millette Jackson-Bates Online Business and CME: Bonnie Chi-Lum, MD, MPH (publisher)

Director: Curt Reilly Managers: Vida Damijonaitis, Kim Krebs, Thalia Moss Staff: Kathy Braun, Ana Dirksen, Sandra Garzon, Christine Hearne, Amy Postlewait, Trina Rizzo, Barbara Van Wagner

Director: Peter J. Murphy Sales Representatives: John P. Cahill Marketing Services: Nancy Bell Staff: Victoria Anne Acot, Susan Lovenberg, Mirna Monal, Debra Ann Sardo

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Division Director: Vanessa Hayden Directors: Karen Adams-Taylor, Paul Gasiecki, Sue Sherrill Managers: David Antos, Karen Branham, Debbie Camp, Diane Darnell, Karl Elvin, Betty Frigerio, Linda Gardner, Mary Ellen Johnston, Mark Matura, Michael McGraw, Phil O'Leary, Susan Price, Charl Richey, Alfred Tomaselli, Carmela Ware Advertising and Production Services: Linda Alexander, LaWanda Brown, Susan Chiara, Mary Anne Donley, Euwanaha Joiner-Smith, Brian McCartney, Sean O'Donnell, Noemi Olmo, Carole Piszker, Sarah Powell, Denise Steinhauser, Ellen Yoshihara Circulation Processing: Bernadette Bauer, Julie Burton, Rosa Eng, Felicia Kyles, Lawrence Majkszak, Kathryn Osten Composition and New Media: Rebecca Aiken, Clifford Barrett, Gail Barrett, Regina Brownlee, Brenda Chandler-Grayer, Rowena Dagang, Amy Evers, Mary Ann Kuranda, Sandra Lopez, John Marcinek, Bruce McGregor, La'son Diggs Sledge, Angela Smits Graphics: Joe Amft, Fred Furtner, Carolyn Hall, Maria Kowalkowski, Chris Meyer, JoAnne Weiskopf Proofreading: Carol Joy Farrell, Daniel James, Judith A. Literskis, Teresa H. Omiotek, Barbara Wojtowicz, Agnes A. Zarkadas

All articles published, including editorials, letters, and book reviews, represent the opinions of the authors and do not reflect the policy of the American Medical Association, the Editorial Board, or the institution with which the author is affiliated, unless this is clearly specified.

Copyright 2003 by the American Medical Association. All rights reserved. Reproduction without permission is prohibited.

Michael D. Maves, MD, MBA Executive Vice President, Chief Executive Officer Robert A. Musacchio, PhD Senior Vice President, Publishing & Business Services