Abstract：
BACKGROUND:The incidence of thyroid cancer is increasing globally. This is mainly due to the increase in the detection of small papillary carcinomas, including papillary microcarcinomas (PMC) 1 cm or smaller. It was suggested recently that PMCs are overdiagnosed and overtreated. METHODS:In 1993, the author proposed a clinical trial to compare surgery and observation for low-risk PMC at doctors' meeting in Kuma Hospital, which was approved and the trial started in the same year. Patients choose immediate surgery or observation. This paper shares our 22-year experience with the active surveillance of more than 2000 patients with low-risk PMC and compares the outcomes of immediate surgery with that of active observation. RESULTS:The oncological outcomes of these management groups were similarly excellent. In our active surveillance trial on 1235 patients, 8% of patients showed tumor enlargement by 3 mm or more at 10 years of observation, and 3.8% of the patients showed novel appearance of lymph node metastasis at 10 years. Patients 40 years or younger tended to show progression of the disease. Patients with these slight progressions of the disease were successfully treated with a rescue surgery. None of the patients in both study groups died of the disease. However, incidences of unfavorable events, such as temporary vocal cord paralysis (VCP) and temporary and permanent hypoparathyroidism, were significantly higher in the immediate surgery group than in the observation group (4.1 vs. 0.6%, p < 0.0001; 16.7 vs. 2.8%, p < 0.0001; and 1.6 vs. 0.08%, p < 0.0001, respectively). Permanent VCP occurred in two of the surgery group. CONCLUSIONS:As a result, although we still offer two options, immediate surgery or observation, to patients with low-risk PMC at Kuma Hospital, we now strongly recommend observation as the best choice.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Miyauchi Adoi
10.1007/s00268-015-3392-ysubject
Has Abstractpub_date
2016-03-01 00:00:00pages
516-22issue
3eissn
0364-2313issn
1432-2323pii
10.1007/s00268-015-3392-yjournal_volume
40pub_type
杂志文章abstract：BACKGROUND:It is generally believed that the accompanying conditions in patients with inflammatory bowel disease (IBD) are associated with a high incidence of surgical site infection (SSI), and sometimes these patients are classified as compromised hosts without definitive clinical evidence. The aim of this study was t...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-9934-4
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Connective tissue growth factor (CTGF) expression changes variously in different human malignancies. The role of CTGF in hepatocellular carcinoma (HCC) is still not clear. The purpose of this study was to investigate the role of serum CTGF in patients with HCC and its correlation with HCC angiogenesis. METH...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0648-4
更新日期：2010-10-01 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
abstract：BACKGROUND:Sometimes, it seems to be difficult to preserve the aberrant hepatic artery (HA) during pancreaticoduodenectomy (PD), with respect to en bloc lymph node dissection, especially in the case of aberrant right hepatic artery (RHA). Therefore, we evaluated the influence of incomplete en bloc lymph node (LN) disse...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0063-x
更新日期：2009-08-01 00:00:00
abstract：BACKGROUND:Idiopathic granulomatous mastitis (IGM) is a rare, benign, and chronic disease of the breast. Despite the various treatment approaches described for this disease, a gold standard treatment modality has not yet been defined. In this study, the effect of topical steroids was reviewed and assessed in patients w...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3147-9
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:The manifestations associated with non-survival after multiple trauma may vary importantly between countries and institutions. The aim of the present study was to assess the quality of performance by comparing actual mortality rates to the literature. METHODS:The study involved evaluation of a prospective c...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0193-1
更新日期：2009-11-01 00:00:00
abstract：PURPOSE:This study was designed to assess the chronological change in health-related quality of life (HRQOL) following robot-assisted distal gastrectomy (RADG) for early gastric cancer (EGC) and to compare the HRQOL of the patients undergoing RADG with that of the general population. METHODS:Patients undergoing RADG f...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2390-1
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:Pheochromocytoma with synchronous ipsilateral adrenal cortical adenoma (PSCA) may present with mixed clinical, biochemical, and radiological features characteristic to each neoplasm subtype. METHODS:All patients with a pathological diagnosis of pheochromocytoma were evaluated for an ipsilateral cortical ade...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4110-8
更新日期：2017-12-01 00:00:00
abstract：:A semiquantitative assessment of multiple histological parameters was applied retrospectively to 66 patients with stage I and II squamous cell carcinoma of the floor of the mouth to determine if prognostic information relative to cervical node metastases could be obtained. Three parameters relating to the tumor cell p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658802
更新日期：1990-09-01 00:00:00
abstract：BACKGROUND:Single-incision laparoscopic cholecystectomy (SILC) has been increasingly performed recently. Although it seems plausible that SILC will be associated with less pain compared to standard 4-port laparoscopic cholecystectomy (LC), there is currently no conclusive comparative study on the postoperative pain iss...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0842-4
更新日期：2011-02-01 00:00:00
abstract：:Patients with short bowel syndrome (SBS) receiving total parenteral nutrition (TPN) have a high incidence of catheter-related sepsis, one of its major complications. The aim of this study was to correlate the length of remaining small bowel (RSB) with septic episodes related to the central venous catheter in a group o...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680010274
更新日期：2000-12-01 00:00:00
abstract：:Recently, surgical services have been gaining greater attention as an integral part of public health in low-income countries due to the significant volume and burden of surgical conditions, growing evidence of the cost-effectiveness of surgical intervention, and global disparities in surgical care. Nonetheless, there ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0585-2
更新日期：2010-11-01 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：:We sought to determine whether early eschar excision en masse (EEE) at one operation would be effective in the prevention and treatment of postburn organ dysfunction (OD) and multiple organ dysfunction syndrome (MODS). A total of 60 patients, with total body surface burned area over 35% and a third degree burn area ov...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900661
更新日期：1999-12-01 00:00:00
abstract：INTRODUCTION:Despite formal definitions of mucinous cystic neoplasms (MCNs) and intraductal papillary neoplasms (IPMNs) by the World Health Organization (WHO) and Armed Forces Institute of Pathology (AFIP), several controversies with regard to MCNs remain. The aim of this review was to determine the clinicopathological...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-006-0126-1
更新日期：2006-12-01 00:00:00
abstract：:Tamoxifen is being used successfully in breast cancer patients as adjuvant hormonal therapy. The aim of this retrospective cohort study is to evaluate the impact of tamoxifen on gallstone formation in postmenopausal breast cancer patients. A total of 3165 patients who were treated for invasive breast cancer between 19...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6468-4
更新日期：2003-04-01 00:00:00
abstract：:Surgical innovation relies on patient safety and quality of life, which require a drastic iatrogenic impact reduction. A parallel development toward less invasive approaches has occurred in the field of surgery, interventional radiology, and endoscopy. Minimally invasive techniques provide unquestionable benefits to p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2879-2
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Binding of the lectin Helix pomatia agglutinin (HPA) has been shown to be associated with poor prognosis in many human cancers, but not in thyroid cancer. The aims of the present study were to assess alteration in cellular glycosylation, detected by HPA binding, in thyroid tumors; to determine if such altere...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1196-2
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS:A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014....
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4087-3
更新日期：2017-11-01 00:00:00
abstract：:Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900118
更新日期：1996-09-01 00:00:00
abstract：:Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinic...
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：: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：BACKGROUND:The aim of the present study was to evaluate the efficacy of cholestyramine ointment (15 %) in reducing postoperative pain at rest and during defecation after open hemorrhoidectomy. METHODS:A total of 91 patients with third and fourth degree hemorrhoids undergoing open hemorrhoidectomy were included in this...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-012-1895-3
更新日期：2013-03-01 00:00:00
abstract：:The acid-base balance from the postoperative day (POD) 1 to POD 3 after cirrhotic liver resection was investigated in relation to operative outcome by conducting a retrospective study on the changes in arterial ketone body ratio (AKBR), which reflects the hepatic mitochondrial redox state, and arterial blood gas analy...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01655722
更新日期：1993-01-01 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：BACKGROUND:Most reconstructive surgery in Sub-Saharan Africa is provided by numerous noncoordinated individuals and organizations, in multiple short trips, or "surgical blitzes." Because many such groups do not train local surgeons, these communities have become dependent on unsustainable systems. By providing much-nee...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0256-3
更新日期：2010-03-01 00:00:00
abstract：BACKGROUND:In the past decade, Enhanced Recovery after Surgery (ERAS) protocols have been implemented in several fields of surgery. With these protocols, a faster recovery and shorter hospital stay can be accomplished without an increase in morbidity or mortality. The purpose of this study was to review systematically ...
journal_title：World journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00268-013-2044-3
更新日期：2013-08-01 00:00:00
abstract：BACKGROUND:Little is known of the oncological outcomes after adjuvant FOLFOX chemotherapy in patients with stage III colon cancer showing microsatellite instability high (MSI-H). In the present study we investigated the prognostic impact of MSI-H in patients with stage III colon cancer receiving FOLFOX chemotherapy. M...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2120-8
更新日期：2013-10-01 00:00:00
abstract：BACKGROUND:Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non-dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze-out technique facilitating duct-to-mucosa anastomosis. We compared the per...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3659-y
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:Our aim was to evaluate the advantages and limitations of delayed laparoscopic cholecystectomy (LC) in a tertiary center. MATERIALS AND METHODS:A retrospective analysis of all patients admitted to our institution with acute calculous cholecystitis (ACC) between January 2003 and December of 2012 was performe...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-3928-4
更新日期：2017-07-01 00:00:00
