Abstract：
:The goals of operative treatment of primary hyperparathyroidism are (1) cure; (2) minimal invasion; and (3) cost-effectiveness. The optimal strategy is controversial. Retrospective review of was undertaken 66 previously unoperated patients having minimal-incision, full-neck exploration by one surgeon over 29 months. A group of 51 women and 15 men had open full neck exploration under general anesthesia through a small (25-40 mm) incision using specifically selected instruments; patients remained hospitalized overnight. Preoperative sestamibi scans were obtained before referral for 17 patients: 11 had localized disease, and 6 did not (65% sensitivity). Four parathyroid glands were identified in 98% of patients; intraoperative frozen section was used selectively on a median of one gland per patient. About 76% of patients had single-gland disease, 6% had two-gland disease, and 18% had four-gland hyperplasia. One patient had four normal cervical parathyroid glands and an aortopulmonary window parathyroid adenoma resected at thoracotomy 1 week later; preoperative sestamibi scans failed to localize his disease. There were no nerve injuries and a 98% cure rate after initial cervical exploration. Excluding the cost of the sestamibi scans, there was no difference between those who had preoperative localization and those who did not; 60% of hospital costs were operating room time-related. Minimal-incision parathyroidectomy is effective for curing hyperparathyroidism and has excellent cosmetic results with negligible scar. Preoperative sestamibi scanning had no impact on cure or treatment costs. Strategies to improve cost-effectiveness must address the substantial costs of anesthesia and operating room services.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Lowney JK,Weber B,Johnson S,Doherty GMdoi
10.1007/s002680010238keywords:
subject
Has Abstractpub_date
2000-11-01 00:00:00pages
1442-5issue
11eissn
0364-2313issn
1432-2323pii
10.1007/s002680010238journal_volume
24pub_type
杂志文章abstract：:The present prospective clinical study was carried out to investigate the effect of age on mortality, morbidity, and readmission rates after coronary artery bypass grafting (CABG). Data on 1131 consecutive CABG patients were collected in a surgical center and in all 18 secondary referral hospitals up to 3 months after...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7033-5
更新日期：2003-12-01 00:00:00
abstract：:Transcutaneous laryngeal ultrasonography (TLUSG) is a promising alternative to laryngoscopy in vocal cords (VCs) assessment which might be challenging in the beginning. However, it remains unclear when an assessor can provide proficient TLUSG enough to abandon direct laryngoscopy . Eight surgical residents (SRs) witho...
journal_title：World journal of surgery
pub_type： 历史文章,杂志文章
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更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:We aimed to systematically review the literature on the educational impact of Advanced Trauma Life Support (ATLS) courses and their effects on death rates of multiple trauma patients. METHODS:All Medline, Pubmed, and the Cochrane Library English articles on the educational impact of ATLS courses and their e...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-013-2294-0
更新日期：2014-02-01 00:00:00
abstract：:This study aimed (1) to develop a simple scoring system incorporating ultrasound (US) examination and clinical or laboratory predictors for increasing diagnostic accuracy in acute appendicitis (AA), and (2) to evaluate the performance of the scoring system as compared to that of previous models. Fifteen variables incl...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-7853-6
更新日期：2005-09-01 00:00:00
abstract：:Factors influencing postoperative hospital mortality and long-term survival after radical resection of stage IV gallbladder carcinoma remain unclear. The objective of this study was to identify characteristics of patients who are good candidates in terms of surgical risk and long-term survival for radical resection of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6654-4
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2886-3
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4438-0
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9218-9
更新日期：2007-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-1906-z
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2451-0
更新日期：2014-06-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3207-1
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:Exact tissue identification during parathyroidectomy is essential to successfully cure hyperparathyroidism. PTH level determination from tissue aspirates has been advocated as a "biochemical frozen section" for parathyroid tissue identification. We investigated the sensitivity and specificity of this method ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0351-5
更新日期：2010-03-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-4062-4
更新日期：2002-07-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05344-w
更新日期：2020-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2777-7
更新日期：2015-01-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05177-7
更新日期：2020-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-004-7641-8
更新日期：2004-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05096-7
更新日期：2019-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0301-9
更新日期：2006-04-01 00:00:00
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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
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/pl00012372
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:Alternative methods to overcome limitations of electromyogram (EMG) tube applied for intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) during thyroidectomy have been introduced. In this study, we evaluated the feasibility of adhesive skin electrodes for IONM of RLN in patients who unde...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05208-3
更新日期：2020-01-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1892-6
更新日期：2013-04-01 00:00:00
abstract：:Endoscopic ultrasonography (EUS) and computed tomography (CT) should be used as complementary methods for TNM staging of esophageal cancer. EUS is the most accurate modality for staging primary tumor and mediastinal lymph node metastases. CT should be used to detect infiltration of other mediastinal organs and distant...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF00316809
更新日期：1994-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7462-9
更新日期：2005-01-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0522-4
更新日期：2010-07-01 00:00:00
abstract：INTRODUCTION:The utilization of laparoscopy in colorectal surgery is increasing. However, conversion to open surgery remains relatively high. OBJECTIVE:We evaluated (1) conversion rates in laparoscopic colorectal surgery; (2) the outcomes of converted cases compared with successful laparoscopic and open colorectal ope...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-2958-z
更新日期：2015-05-01 00:00:00
abstract：INTRODUCTION:This study assesses the incidence of missed pelvic injuries in the pre-hospital setting. METHODS:All blunt trauma patients (ISS ≥ 9) with pre-hospital suspicion of and/or radiologically proven pelvic fracture documented in the TraumaRegister DGU® (TR-DGU) of the German Trauma Society DGU (2002-2011) were ...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-016-3647-2
更新日期：2016-12-01 00:00:00
