Abstract:
BACKGROUND:Substernal thyroidectomy (ST), as compared to conventional, cervical thyroidectomy, is a technically demanding procedure that is associated with increased morbidity and mortality. We tested the hypothesis that outcomes following ST are improved at centers that perform a high volume of thyroidectomies. METHODS:Patients who underwent ST from 1998 to 2004 were extracted from the New York State Statewide Planning and Research Cooperative System database. Hospital volume of thyroidectomies was divided into low (<33 per year), middle (33-99 per year), and high (>or=100 per year) volumes. Outcome variables included hospital length of stay (LOS), recurrent laryngeal nerve (RLN) injury, hypoparathyroidism, postoperative bleeding, respiratory failure, blood transfusion, and mortality. RESULTS:A total of 1153 STs were analyzed; 372 (32.2%) were performed at low-volume centers, 388 (33.7%) at middle-volume centers, and 393 (34.0%) at high-volume centers. Linear associations were observed between increasing hospital volume of thyroidectomies and decreasing age (p=0.003), increasing co-morbidity (p<0.0001), increased likelihood of total versus subtotal thyroidectomy (p<0.0001), and increased likelihood of thyroid malignancy (p<0.0001). Despite this, increasing hospital volume of thyroidectomies predicted a decreased likelihood of overall complications (p=0.005), postoperative bleeding (p=0.01), blood transfusion (p=0.04), respiratory failure (p=0.04) and mortality (p=0.004), as well as a trend toward a decreased LOS (p=0.06). The overall complication rate and the mortality rate remained significantly associated with volume group by multivariate analysis. CONCLUSION:Despite more extensive surgery on patients with greater co-morbidity, LOS, morbidity, and mortality were all decreased when ST occurred at hospitals that perform a high volume of thyroidectomies.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Pieracci FM,Fahey TJ 3rddoi
10.1007/s00268-007-9347-1subject
Has Abstractpub_date
2008-05-01 00:00:00pages
740-6issue
5eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract::In 1989-90, all 37 lung cancer patients scheduled for surgery underwent transesophageal endoscopic ultrasonography (EUS) for pre-operative detection of hilar and mediastinal lymph node metastases. An electronic ultrasonic fiberscope with a linear array (EPB-503-FS, Machida-Toshiba) was used. Of 380 nodes surgically re...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067013
更新日期:1992-09-01 00:00:00
abstract:AIMS:Post-operative urinary retention (POUR) is a common cause of unplanned admission following day-case surgery and has negative effects on both patient and surgical institution. We aimed to prospectively evaluate potential risk factors for the development of POUR following day-case general surgical procedures. METHO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4697-4
更新日期:2018-12-01 00:00:00
abstract::Dukes' classification is a useful staging system in patients with colorectal cancer. The aim of this study was to present clinicopathologic characteristics and survival of patients with gastric cancer based on Dukes' classification. A total of 273 patients with gastric cancer curatively treated by radical gastrectomy ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012338
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Few guidelines exist for the initial management of wounds in disaster settings. As wounds sustained are often contaminated, there is a high risk of further complications from infection, both local and systemic. Healthcare workers with little to no surgical training often provide early wound care, and where r...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2663-3
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Surgical resection remains the treatment of choice for carotid body tumors (CBTs). Although perioperative complications such as carotid artery injury and neurological deficits occur infrequently, they can be devastating. The aim of this study was to evaluate whether clinical factors or preoperative imaging f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3058-9
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the prognostic factors associated with long-term outcome after liver resection for colorectal metastases. The retrospective analysis included 297 liver resections for colorectal metastases. METHODS:The variables considered included disease stage, differentiation grade, s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9285-y
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Finnmark County is the northernmost county in Norway. For several decades, the rate of mortality after injury in this sparsely inhabited region has remained above the national average. Following documentation of this discrepancy for the period 1991-1995, improvements to the trauma system were implemented. Th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1102-y
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The recent development and spread of ultrasonography and ultrasonography-guided fine needle aspiration biopsy (FNAB) has facilitated the detection of small papillary microcarcinomas of the thyroid measuring 1 cm or less (PMC). The marked difference in prevalence between clinical thyroid carcinoma and PMC det...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0303-0
更新日期:2010-01-01 00:00:00
abstract::Squamous cell carcinoma of the anus (SCCA) is a rare disease in the average population but is an increasing concern among immunocompromised individuals, such as the HIV-seropositive. Coinfection with human papillomavirus (HPV) in this population is common. HPV infection is difficult to clear with a compromised immune ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-008-9835-y
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Ultrasound (US) and sestamibi (MIBI) are traditionally considered positive or negative. The purpose of this study was to define and test a new scoring system for MIBI and US and to determine whether this can improve their accuracy for primary hyperparathyroidism. METHODS:This is a prospective study of 200 c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1666-1
更新日期:2012-10-01 00:00:00
abstract:PURPOSE:The prognosis for stage III melanoma patients is mixed, and there is need for new prognostic factors to be incorporated into a revision of melanoma TNM staging. We analyzed the possible role of the timing of lymph node involvement as an important prognostic factor. METHODS:Among 249 melanoma patients who under...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9895-z
更新日期:2009-03-01 00:00:00
abstract::The eponym "Graves' disease" is usually applied to the condition of immunogenic hyperthyroidism, in no small part due to the promotion and influence of the French physician Armand Trousseau who wrote in 1862, "Du Goître Exophthalmique, ou Maladie de Graves." However, the distinguished Bath physician Caleb Hillier Parr...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00268-009-0297-7
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND AND AIMS:A variety of minimally invasive techniques have been proposed to replace open surgery for the treatment of infected pancreatic necrosis (IPN). In this study, we evaluate the feasibility and safety of the stent-assisted percutaneous endoscopic necrosectomy (SAPEN) procedure. METHODS:Data were collec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-04878-9
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Appendiceal neuroendocrine tumors (aNET) are a common entity in routine medical care, with a rate per appendectomy as high as 0.3-0.9 %. Considering the relatively young age at diagnosis for these patients, exact information about the long-term prognosis of aNET is required. Survival rates vary substantially...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3164-8
更新日期:2015-11-01 00:00:00
abstract::Neoadjuvant therapy for locally advanced breast cancer improves disease control, but the complications of treatment are not well established. The aim of this study was to assess the operative morbidity in 20 consecutive patients with locally advanced, noninflammatory breast cancer treated with preoperative chemotherap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658934
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery. METHO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2680-2
更新日期:2014-12-01 00:00:00
abstract::Those benign breast disorders that are amenable to improvement by aesthetic surgery are discussed from the points of view of indications, techniques, and results. ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658430
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Intraoperative cerebral oxygen desaturation was reported to be associated with postoperative cognitive dysfunction in elderly patients. The effect of the anesthesia method on regional cerebral oxygen saturation (rSO(2)) is still a question under debate. The purpose of this study was to compare the effects of...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1676-z
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4511-3
更新日期:2018-08-01 00:00:00
abstract::Subfascial elimination of incompetent perforating veins is the most effective therapeutic principle in the treatment of trophic skin disorders associated with varicosis. A recently developed endoscopic technique allows accurate sectioning of perforating veins with direct observation of the veins and minor trauma. From...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067007
更新日期:1992-09-01 00:00:00
abstract:INTRODUCTION:Large incisional hernias with loss of domain (LIHLD) of the abdominal wall remain a therapeutic challenge due to the difficulty of replacing the contents of the hernia sac into the peritoneal cavity. Preoperative progressive pneumoperitoneum (PPP) is a valuable option. The purpose of this study was to eval...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3206-2
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Liver transplantation for biliary atresia is indicated whenever a Kasai portoenterostomy is considered unfeasible. However, the timing of liver transplantation in biliary atresia has not been precisely defined. Excessive shortening of hepatocellular telomeres may occur in patients with biliary atresia, and t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1453-z
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Surgical treatment of amiodarone-associated thyrotoxicosis (AAT) is effective although fewer than 100 cases have been reported world wide. MATERIALS AND METHODS:We reviewed 14 patients treated with total thyroidectomy by a single surgeon from 1998 to 2005. RESULTS:There were 11 male and 3 female patients w...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0673-x
更新日期:2006-11-01 00:00:00
abstract::Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. However, to our best knowledge, at least 163 cases of functioning parathyroid carcinoma appeared in the English literature from 1981 to 1989. We summarize the available information obtained from the reports of those patients and compare it with prev...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01665308
更新日期:1991-11-01 00:00:00
abstract:INTRODUCTION:Percutaneous needle biopsy (PNB) is the standard of care for diagnosis of breast lesions. Rates of excisional biopsy for breast diagnosis in North America have been reported at approximately 35 %, although significant regional variation exists. A target rate of PNB for diagnosis of breast abnormalities is ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3293-0
更新日期:2016-07-01 00:00:00
abstract::Hepatectomy with concomitant resection of the inferior vena cava (IVC) has become common for hepatic malignancies involving the IVC. However, diagnosing IVC invasion and the procedure of choice have yet to be standardized. Medical records of nine patients with liver cancer (five metastatic tumors from colorectal cance...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6908-9
更新日期:2003-06-01 00:00:00
abstract::Fourteen patients with liver tumor malignancy and sixteen patients with malignant melanoma localized to one limb were studied regarding leukocyte activation with the release of polymorphonuclear neutrophilic (PMN) elastase and of neopterin and formation of cytokines (TNF-alpha and IL-6) during the surgical treatment. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00299787
更新日期:1995-11-01 00:00:00
abstract::Quality of life is an important outcome measure following surgery for ulcerative colitis. Quality of life incorporates not only the physical or functional outcome; it also considers the emotional and social well-being of patients. Quality of life may be measured using disease-specific or generic quality of life measur...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900400
更新日期:1998-04-01 00:00:00
abstract::The surgical treatment of 30 cases of vascular thoracic outlet syndrome (TOS) in 25 patients is presented. Patients included 17 women and 8 men with average age of 26.1 years. The causes of compression were cervical rib ( n = 16), soft tissue anomalies ( n = 12), and scar tissue after clavicle fracture ( n = 2). Ten s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6808-z
更新日期:2003-05-01 00:00:00
abstract::In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02393582
更新日期:1980-01-01 00:00:00