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::Expression of sialyl-Lewisx (sLex) antigen was studied immunohistochemically in 110 resected human gastric carcinomas using an anti-sLex monoclonal antibody. Lymph node, liver, and peritoneal metastases were clearly more prevalent in tumors expressing high levels of sLex than in those with no or low-level sLex express...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900304
更新日期:1997-09-01 00:00:00
abstract:INTRODUCTION:Acute intestinal ischemia is in most cases a lethal condition with a low survival rate. Risk factors of perioperative mortality are poorly defined. The aim of this study was to define risk factors that predict an adverse outcome of acute mesenteric ischemia (AMI). METHODS:A total of 132 consecutive patien...
journal_title:World journal of surgery
pub_type: 杂志文章
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abstract:BACKGROUND:Laparoscopic incisional and ventral hernia repair (LIVHR) is an alternative approach to conventional open incisional and ventral hernia repair (OIVHR). A consensus on outcomes of LIVHR when compared with OIVHR has not been reached. METHODS:As the basis for the present study, we performed a systematic review...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-014-2578-z
更新日期:2014-09-01 00:00:00
abstract::Although HLA matching can improve organ graft survival, well matched grafts fail and poorly matched ones survive. Recently evidence has been found that perinatal exposure to noninherited antigens (NIMAs) has a lifelong impact on the immune repertoire of the individual. The state of the art of the influence of NIMAs on...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010132
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abstract::Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new a...
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abstract::Precise localization of cervical node metastasis of papillary thyroid carcinoma is rarely described. The aim of this retrospective study was to map their cervical involvement. Between 1974 and 1996 a series of 119 patients had total thyroidectomy with bilateral cervical lymph node dissection. Patients who had secondar...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1999-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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abstract::Dissemination of new surgical knowledge, skills, and techniques across the wide spectrum of practicing surgeons in the community is often difficult and slow. This is even more problematic in countries such as Canada, where geographic distances separate a large portion of community surgeons from the large teaching cent...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9076-5
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:This study was designed to establish the current demographic and treatment patterns of mandibular fractures in two urban centers (Lagos University Teaching Hospital, Lagos, and National Hospital, Abuja) in Nigeria. METHODS:All cases of mandibular fractures diagnosed and treated at the Department of Oral and...
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
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0047-y
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:The fields of surgery and trauma care have largely been neglected in the global health discussion. As a result the idea that surgery is not safe or cost effective in resource-limited settings has gone unchallenged. The SIGN Online Surgical Database (SOSD) is now one of the largest databases on trauma surgery...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1817-4
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine whether rat insulin promoter (RIP) could, in a mouse model, direct expression of an adenovirus-mediated reporter gene specifically into pancreatic islets via systemic delivery. METHODS:Five hundred and eight base pairs of the RIP DNA sequence were constructed int...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0688-3
更新日期:2006-08-01 00:00:00
abstract::Malnutrition in its various forms is without doubt the commonest disease. Acute malnutrition resulting from a total lack of ingestion clearly shows that not only are water and electrolytes a priority for survival but also energy reserves. It also shows that the maximum wasting that the lean body mass can withstand is ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012343
更新日期:1999-06-01 00:00:00
abstract::We evaluated the morbidity associated with primary closure by interrupted subcuticular absorbable sutures following emergency appendectomy. In a prospective clinical trial over a 12-month period, 216 children who underwent emergency appendectomy had skin closure using subcuticular interrupted absorbable polyglactin 4-...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900007
更新日期:1996-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9469-0
更新日期:2008-07-01 00:00:00
abstract:INTRODUCTION:In recent years, surgical providers and advocates have engaged in a growing effort to establish metrics to estimate capacity for surgical services as well the burden of surgical diseases in resource-limited settings. The burden of disease (BoD) studies have established the disability-adjusted life year (DA...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2182-7
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Concurrent vitamin D(3) deficiency is common in primary hyperparathyroidism (pHPT). We aimed to examine the clinicopathologic features and short-term outcomes of vitamin D(3)-deficient patients after minimally invasive parathyroidectomy (MIP). METHODS:Over 2-year period, 80 consecutive MIP patients had preo...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0377-8
更新日期:2010-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0627-3
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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/s00268-017-3964-0
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05165-x
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/s00268-018-4514-0
更新日期:2018-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01664871
更新日期:1990-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05313-3
更新日期:2020-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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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
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00348205
更新日期:1994-01-01 00:00:00