Abstract:
BACKGROUND:Total thyroidectomy is a well-established surgical approach for the management of papillary thyroid cancer (PTC). However, the best surgical approach for papillary microcarcinoma is nowadays still debated. Both total thyroidectomy and simple lobectomy are used. We report the experience of a single University center in the treatment of thyroid microcarcinoma. METHODS:A retrospective analysis on all patients who underwent thyroid surgery at our institution over a 24-year period (1991-2015) was performed. Patients were grouped according to whether they received total thyroidectomy (Group 1) or lobectomy (Group 2). Follow-up was made by routine clinical and ultrasound examination. Specific outcomes such as recurrence and need for reoperation as well as complications (transient vocal cord paralysis and hypocalcemia) were analyzed. RESULTS:During the study period 880 patients underwent surgery for PTC. Group 1 and 2 consisted, respectively, of 756 and 124 patients. A micro PTC (<10 mm) was present in 251 and 69 specimen of Group 1 and 2. No evidence of disease recurrence in the follow-up was reported in patients with microPTC in Group 1 and in 57 patients of Group 2. In the remaining 12 patients completion thyroidectomy was carried out due to ultrasound findings of contralateral nodules (10), lymphadenopathy (1), and capsular invasion (1). Five of these patients had a contralateral papillary carcinoma on final histopathologic examination. Thus recurrence rate for patients of Group 2 was 7.3%. Morbidity rates were, respectively, for Group 1 and 2: transient nerve palsy 81 and 5 (11 vs. 7.3%, p = ns), transient hypoparathyroidism (Calcium <2.00 mmol/L) 137 (18.6%) and 0 (p < 0.0001). Three of the 12 patients of Group 2 undergoing further surgery had a transient hypoparathyroidism. CONCLUSIONS:Thyroid lobectomy is an effective surgical strategy to manage papillary microcarcinomas with low complications. Routine completion thyroidectomy is not mandatory. Appropriate selection excluding high-risk patients is of paramount importance in order to achieve the best results.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Donatini G,Castagnet M,Desurmont T,Rudolph N,Othman D,Kraimps JLdoi
10.1007/s00268-015-3327-7subject
Has Abstractpub_date
2016-03-01 00:00:00pages
510-5issue
3eissn
0364-2313issn
1432-2323pii
10.1007/s00268-015-3327-7journal_volume
40pub_type
杂志文章abstract:BACKGROUND:Nonoperative management (NOM) of kidney gunshot injuries as an alternative to surgical exploration is rarely reported. The aim of this study was to assess the feasibility and safety of selective NOM of such injuries. METHODS:A 4-year prospective study was conducted that included all patients admitted to a L...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9888-y
更新日期:2009-03-01 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
abstract::During the period 1979 to 1989, 0.1% of all cases of acute appendicitis at our institution occurred soon after another operative procedure. The interval between primary operation and appendectomy was 5 to 31 days (mean, 14 days). Signs and symptoms did not differ from those of classical acute appendicitis. Duration of...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01675654
更新日期:1991-07-01 00:00:00
abstract::Although peptic gastroduodenal ulcers are rarely treated surgically today, when surgery is required a laparoscopic approach is possible with its well known advantages. The most widely used technique is vagotomy by various modalities. Training in laparoscopy requires good instrumentation to avoid complications. Vagotom...
journal_title:World journal of surgery
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abstract::Previous analysis of this prospective randomized trial and meta-analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis....
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-08-01 00:00:00
abstract::A review of the literature describing the management of hepatic and splenic injuries indicates that as many as 67% of exploratory celiotomies for blunt trauma are reported as nontherapeutic. Avoiding unnecessary surgery through nonoperative management offers an attractive alternative. Nonetheless, nonoperative managem...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Every day thousands of surgeons and patients negotiate their way through the complex process of decision-making about operative treatments. We conducted a series of qualitative studies, asking patients and surgeons to describe their experience and beliefs about informed decision-making and consent. This stud...
journal_title:World journal of surgery
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doi:10.1007/s00268-009-0021-7
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abstract:BACKGROUND:Laparoscopic proximal gastrectomy (LPG) is performed as a function-preserving surgery for patients with early proximal gastric malignant tumors; however, whether LPG has advantages postoperatively compared with laparoscopic total gastrectomy (LTG) is debatable, especially with regard to nutritional outcomes....
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4625-7
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The World Health Organization has a standardized tool to assess surgical capacity in low- and middle-income countries (LMICs), but it is often resource- and time-intensive. There currently exists no simple, evidence-based measure of surgical capacity in these settings. The proportion of cesarean deliveries i...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1794-7
更新日期:2013-07-01 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::Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2001-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9197-x
更新日期:2007-11-01 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
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更新日期:1996-01-01 00:00:00
abstract::Radiation-induced proctitis with hemorrhage is not a common complication of radiotherapy to the pelvis for carcinoma. In the most severe forms, massive hemorrhage may necessitate repeated transfusions and inpatient treatment. In severe cases medical treatment has not been proved effective. Surgery may lead to serious ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900166
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Minimally invasive radio-guided parathyroidectomy (MIRP) has been embraced as an acceptable therapeutic approach to primary hyperparathyroidism. Preoperative sestamibi scanning has facilitated this technique. Here we evaluate the addition of a rapid intraoperative parathyroid hormone (iPTH) assay for patient...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0293-5
更新日期:2006-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1138-z
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS:The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4083-7
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Although ultrasonographic (US) evaluation is currently recommended for the workup of all palpable thyroid nodules, little guidance exists regarding the manner in which US data are to be used. Herein, we examine the available evidence and recommend how US can be used most effectively to predict malignancy. We...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-008-9494-z
更新日期:2008-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2243-y
更新日期:2014-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2016-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2653-5
更新日期:2014-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900609
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
doi:10.1007/s002689900418
更新日期:1998-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9321-y
更新日期:2008-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4494-0
更新日期:2018-08-01 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:BACKGROUND:The aim of this study was to evaluate and investigate the complications of carotid endarterectomy (CEA) and carotid artery stenting (CAS) by performing a meta-analysis based on prospective randomized controlled trials (RCTs). METHODS:We performed a search of multiple electronic databases for RCTs containing...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-008-9862-8
更新日期:2009-03-01 00:00:00
abstract::In spite of recent therapeutic advances, severe overt secondary hyperparathyroidism due to chronic renal failure necessitates parathyroidectomy and recurrent hyperparathyroidism is one of the most significant problems in this patient population. In the present study, the incidence of recurrent hyperparathyroidism was ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067331
更新日期:1992-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-010-0422-7
更新日期:2010-05-01 00:00:00
abstract::Blood loss during liver transection and ischemia-reperfusion injury associated with hepatic inflow occlusion are significant drawbacks during liver surgery. Sixteen patients underwent liver resection using the Monopolar Floating Ball (FB) plus LigaSure (LS) diathermy without occlusion of the hepatoduodenal ligament (g...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2004-02-01 00:00:00