Abstract:
:Most people would agree that successful parathyroidectomy depends on two important variables: the surgeon's recognition and excision of the abnormal parathyroid gland(s) and the pathologist's confirmation that the removed tissue is parathyroid tissue. Frozen section is usually employed to confirm the identity of parathyroid tissue, but occasionally confirmation cannot be made without a permanent section, as with intrathyroidal glands. This study proposes a new method of expeditious and easy confirmation of parathyroid tissue utilizing the immunoassay for quick measurement of intraoperative parathyroid hormone (IOPTH). By directly aspirating the suspected adenoma, the assay becomes a rapid diagnostic tool that can be used as an alternative to frozen section. In cases where the surgeon is already planning to employ the assay, the elimination of frozen section is cost-effective. Intraoperative aspiration of histologically confirmed parathyroid adenomas was performed on 12 consecutive patients undergoing parathyroid surgery. Parathyroid glands were aspirated with a 22-gauge syringe after gland excision. Aspirates were placed in 1 to 3 ml of buffered saline. A similar process was performed on 12 thyroid controls. Specimens were centrifuged, aliquotted, and stored at -70 degrees C. The parathyroid hormone value was analyzed electively by rapid assay and the values recorded. For all parathyroid aspirates, the rapid assay value was > 1500 pg/ml, exceeding the uppermost limit of the diagnostic chart. Values for thyroid aspirates ranged from 58 to 85 pg/ml (mean 75.7 pg/ml). In all cases tissue confirmation was achieved with permanent section. Values were 100% sensitive and specific. Measurement of PTH from intraoperative aspiration of suspected parathyroid adenomas is clinically useful in patients for whom frozen section would routinely be employed. Values > 1500 pg/ml secure the tissue diagnosis. There is no additional cost in cases where IOPTH monitoring is already being utilized to confirm cure. The elimination of frozen section could be cost-effective and, for some institutions, actually decrease the operating time as the IOPTH assay takes only 15 minutes. PTH assay is an accurate diagnostic technique and to date is 100% sensitive and specific for differentiating between parathyroid tumors and thyroid nodules.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Perrier ND,Ituarte P,Kikuchi S,Siperstein AE,Duh QY,Clark OH,Gielow R,Hamill Tdoi
10.1007/s002680010218keywords:
subject
Has Abstractpub_date
2000-11-01 00:00:00pages
1319-22issue
11eissn
0364-2313issn
1432-2323pii
10.1007/s002680010218journal_volume
24pub_type
杂志文章abstract::The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 1...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7389-1
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the therapeutic efficacy of two surgical procedures used to treat middle thoracic esophageal squamous cell carcinoma and compare the results. METHODS:A total of 167 patients with middle thoracic esophageal squamous cell carcinoma were included in the study, including 10...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0341-7
更新日期:2010-02-01 00:00:00
abstract::There are many concepts of risk and prognostic factor analysis for differentiated thyroid cancer. The prognostic role of lymph node metastases in follicular thyroid cancer (FTC), however, is still controversial. We performed a retrospective trial in 186 patients with FTC (124 women, 62 men; mean follow-up 5.5 years) q...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6668-y
更新日期:2002-08-01 00:00:00
abstract::Recent collective reviews have outlined when and how surgeons should treat patients with bile duct injuries after laparoscopic cholecystectomy (LC). However, little is described about other injuries combined with bile duct injuries, for example, hepatic arterial injury and secondary biliary cirrhosis. Fifteen patients...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0120-6
更新日期:2001-10-01 00:00:00
abstract::It is a fundamental clinical observation that wounds do not heal in tissue that does not bleed, and they almost always heal in tissue that bleeds extensively. Continuous supply of oxygen to the tissue through microcirculation is vital for the healing process and for resistance to infection. Evaluation of tissue perfus...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7398-5
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Emerging evidences have gradually revealed the skeletal muscle attenuation (MA) was not only reflected the accumulation of lipids in skeletal muscle but also associated with physiological and pathological states. The aim of this study was to evaluate the impact of MA on the prognosis of pancreatic cancer pat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3205-3
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Our laboratory has previously shown that the levels of secreted prostaglandin E(2) (PGE(2)), Thromboxane B(2) (TxB(2)), and interleukin-6 (IL-6) by aortic explant cultures were high in patients with ruptured abdominal aortic aneurysm (AAA). In the present study, we sought to examine the secretory levels of t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9279-9
更新日期:2008-01-01 00:00:00
abstract::The previous finding of an increased risk of premature death in a consecutive series of 896 patients operated on for primary hyperparathyroidism between 1953 and 1982 [1] raised the question of the role that surgery plays in relation to the risk of death. In the present study, undertaken to examine that issue, 3 facto...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658740
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:This prospective, non-randomized, comparative study evaluated morbidity of chemotherapy administration via a totally implantable venous access device (TIVAD) versus peripheral intravenous access (PIVA), and satisfaction in breast cancer patients in a limited-resource setting. METHODS:Consecutive patients re...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2378-x
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Postoperative outcome prediction in elderly is based on preoperative physical status but its predictive value is uncertain. The goal was to evaluate the value of risk assessment performed perioperatively in predicting outcome in case of admission to an intensive care unit (ICU). METHODS:A total of 108 posts...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05742-5
更新日期:2020-12-01 00:00:00
abstract::Cancers of the distal rectum (less than 7.5 cm from the anal verge) that are freely mobile, moderately well or well differentiated, less than 4 cm in size, limited to the bowel wall, and without evidence of metastasis should be considered candidates for treatment with electrocoagulation for cure. Tumor cell ploidy and...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02104447
更新日期:1992-05-01 00:00:00
abstract::This article attempts to put into a risk-related perspective modern red blood cell (RBC) transfusion therapy. When making the decision to transfuse, RBCs or blood products, it is important to weigh the risks and benefits of the proposed therapy. It is equally important to evaluate the risk of not transfusing and the m...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900181
更新日期:1996-11-01 00:00:00
abstract:INTRODUCTION:Accidental intraoperative gallbladder perforation is a problem in laparoscopic surgery, especially in cases with incidental gallbladder carcinoma (IGBC). The question is whether intraoperative gallbladder perforation has a prognostic disadvantage or a retrieval bag provides protection against tumor dissemi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0163-7
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplanta...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1318-x
更新日期:2012-01-01 00:00:00
abstract::Although pancreatectomy is still performed in a few patients with pancreatic cancer, and nearly all patients who develop pancreatic cancer eventually die of their disease, significant improvements have been made recently. Pancreatectomy is now safer, with major morbidity (hemorrhage, pancreatic anastomotic leak, intra...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900599
更新日期:1999-09-01 00:00:00
abstract::During laparoscopic cholecystectomy, gallbladder perforation has been reported, leading to bile leak and spillage of gallstones into the peritoneum. Because the consequences can be dangerous, conversion to laparotomy as an instant management for gallstone spillage is one of the topics of current discussion in laparosc...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7588-9
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:The role of preoperative imaging and the usability of different imaging modalities is highly variable and controversial in reduction mammaplasty patients. Our study describes the imaging process in a single center in regard to modality selection, age and timing, and of the association between imaging and his...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3920-z
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Few studies in the literature have reported recovery data for different types of recurrent laryngeal nerve injuries (RLNIs). This study is the first attempt to classify RLNIs and rank them by severity. METHODS:This prospective clinical study analyzed 281 RLNIs in which a true loss of signal was identified b...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3415-3
更新日期:2016-06-01 00:00:00
abstract::This paper reviews aspects of head injury management and research in the United Kingdom (UK). We discuss evidence about the scale and etiology of head injury in Britain and how this information has supported a triage-based approach, incorporating risk analysis. A Cohesive organization based upon nationally accepted, y...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0084-6
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Fast-track surgery (FTS) is a promising program for surgical patients and has been applied to several surgical diseases. FTS is much superior to conventional perioperative care. Our aim was to evaluate and compare the safety and efficacy of FTS and conventional perioperative care for patients undergoing gast...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-014-2690-0
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Across Nepal, anesthesia at a district level is provided mostly by non-doctor anesthesia providers (anesthesia assistants-AAs). Nepal's Government recognized the need to sustain competence with continuous professional development and to upgrade 6-month trained working AAs to professional equivalence with the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4273-3
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Surgery for Graves' disease (GD) is usually performed after adequate control with medical treatment. Occasionally, rapid pre-operative optimization is required. The primary objective was to compare the outcomes of patients undergoing elective surgery for well-controlled GD with those undergoing rapid pre-ope...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05125-5
更新日期:2019-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9197-x
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:This study aimed to evaluate the recurrence rates, timings, locations, and risk factors, and survival in patients with lymph node-negative superficial esophageal squamous cell carcinomas (ESCCs). METHODS:We investigated 167 patients with pathological T1 thoracic ESCC who underwent curative esophagectomy wit...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3454-9
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Three decades of internal conflict in the North and East of Sri Lanka have taken a toll on the health care system in that area. METHODS:We proposed to quantify the current status of capacity to deliver emergency, anesthesia, and surgical interventions in the conflict affected areas of Sri Lanka. The World H...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0254-5
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Retroperitoneal soft tissue sarcomas (RSTS) are a rare and uncommon entity with a poor 5-year overall survival (OS) of approximately 50%, even though they rarely metastasize. The aim of the present study was to analyze the survival of patients with RSTS treated at our institution. PATIENTS AND METHODS:Patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0473-9
更新日期:2010-07-01 00:00:00
abstract::In an attempt to prevent the sequelae of conventional gastrectomy, such as rapid gastric emptying, dumping syndrome, intestinal content reflux, indigestion, and poor absorption, we have devised the pylorus and pyloric vagus preserving gastrectomy (PPVPG). Experimenting on 48 dogs, we found theoretic grounds for using ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01655114
更新日期:1993-07-01 00:00:00
abstract::The objective of this study was to assess the validity and responsiveness of a new quality of life instrument, the Patient Generated Index (PGI), in patients with rectal cancer. Thirty-three patients with rectal cancer were administered the PGI, the European Organisation for Research and Treatment of Cancer (EORTC) Qu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6360-2
更新日期:2002-11-01 00:00:00
abstract::Surgical resection is the treatment of choice for patients with stage I and stage II non-small-cell lung cancer (NSCLC--squamous cell, adenocarcinoma, and large-cell carcinoma). Distant recurrence is an important cause of death after complete surgical resection, occurring in 30-60% of patients. Postoperative adjuvant ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01659083
更新日期:1993-11-01 00:00:00
abstract::The purpose of this study was to elucidate the function of the sphincter of Oddi (SO) in patients with juxtapapillary duodenal diverticula (JDDs). The SO function was evaluated by intraoperative biliary manometry in three groups of patients. Group 1 consisted of nine patients with JDDs and a dilated common bile duct (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00308647
更新日期:1995-03-01 00:00:00