Abstract:
OBJECTIVE:The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS:From January 1996 to December 2014, 5893 consecutive CEAs were performed in our institution. Data concerning these interventions were prospectively inserted in a dedicated database. A retrospective analysis of that database was performed and 457 interventions performed in patients aged 60 or less were found (group 1). The control group was represented by 457 interventions selected from the remaining 5436 by a one-to-one coarsened exact matching on the basis of all the baseline demographic and clinical covariates significantly different in the two groups (group 2). The two groups were compared in terms of intraoperative technical features and perioperative (<30 days) results of interventions (transient ischaemic attack-TIA, stroke and death rates) with χ 2 test. Follow-up data were analysed by life-table analysis (Kaplan-Meier test) in terms of survival, stroke-free and neurological symptom-free survival, freedom from severe restenosis and occlusion and freedom from reintervention, and the results in the two groups were compared by means of log rank test. RESULTS:There were no differences between the two groups in terms of clinical presentation and of degree of carotid stenosis on operated side. Anaesthesiological and surgical details were also similar between the two groups. Thirty-day stroke and death rate was 0.6% in both groups (p = 0.9). Follow-up was available for 877 patients (96% of the study group) with a mean duration of 50 months. Estimated 10-year survival rates were 85% in group 1 (SE 0.03) and 76% in group 2 (SE 0.04, p = 0.003, log rank 8.9). At the same time interval, stroke-free survival was also significantly better in group 1 (85%, SE 0.035) than in group 2 (72.5%, SE 0.03; p = 0.002, log rank 10.1). The corresponding figures in terms of any neurological symptom-free survival were 82.8% in group 1 (SE 0.04) and 70.3% in group 2 (SE 0.04, p = 0.002, log rank 9.7). Estimated freedom from severe restenosis and occlusion was 76.5% in group 1 (SE 0.04) and 88.5% in group 2 (SE 0.035, p = 0.001, log rank 11.9). Disease recurrence was symptomatic in six cases, three in each group. Estimated freedom from reintervention rates at 10 years was 87% in group 1 (SE 0.035) and 91.5% in group 2 (SE 0.03; p = 0.2, log rank 1.1). CONCLUSIONS:CEA in patents aged 60 or less is safe and provides significantly better long-term results than those obtained in patients over 60 in terms of survival and stroke-free survival. Younger patients appear to have higher rates of recurrent carotid stenosis compared to the older cohort; however, these rarely require a secondary intervention.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Dorigo W,Fargion A,Giacomelli E,Bassoli G,Pulli R,Pratesi G,Piffaretti G,Pratesi Cdoi
10.1007/s00268-017-4133-1subject
Has Abstractpub_date
2018-01-01 00:00:00pages
263-271issue
1eissn
0364-2313issn
1432-2323pii
10.1007/s00268-017-4133-1journal_volume
42pub_type
杂志文章abstract:BACKGROUND:Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue. We evaluated whether postoperative diagnosis was associated with long-term QoL and healt...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0032-4
更新日期:2009-07-01 00:00:00
abstract::Carnitine, an important carrier of free fatty acid that is transported into mitochondria for beta-oxidation, was thought to be one of the key factors in the regulation of liver regeneration. If the carnitine content is insufficient in the hepatocyte, it might impair the energy substrate's transport and the energy char...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900347
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Neuroendocrine neoplasia (NEN) with unknown primary site (NEN-CUP tumors) may have a poor prognosis. We evaluated the clinical presentation, therapy, outcome, and risk factors for adverse outcomes in patients who had these tumors. METHODS:In 243 patients who had NEN, a retrospective review was performed in ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2963-2
更新日期:2015-06-01 00:00:00
abstract::Postoperative complications in patients with obstructive jaundice remain increased when associated with endotoxemia and the inflammatory response due to gut barrier failure. Administration of glutamine has been proposed to maintain the integrity of the gut mucosa and thus reduce bacterial translocation (BT), but the e...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7721-4
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Hepatic trisectionectomy is a challenge for surgeons. We describe a technique by combination of the Glisson pedicle method and anterior approach to perform hepatic trisectionectomy. METHODS:In this technique, the Glisson pedicles are isolated above the hilar plate without hilar dissection. After dividing th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2579-y
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Obesity and rapid weight loss after bariatric surgery are risk factors for gallstone disease. OBJECTIVES:The present study sought to evaluate the feasibility of selective concomitant cholecystectomy only in patients with symptomatic disease and study risk factors for the development of symptomatic gallstone...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3639-2
更新日期:2016-12-01 00:00:00
abstract::Mansonic schistosomiasis is an endemic disease in Brazil, with an estimated 10-12 million people infested. Among its clinical manifestations, the hepatosplenic form causes portal hypertension which, in turn, brings about severe digestive hemorrhage, the most serious complication of the disease. Normally, the patients ...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01659051
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Thymic epithelial tumors are characterized by slow growth and variable malignant behavior. We present our experience on the surgical management of these tumors. MATERIALS AND METHODS:We conducted a retrospective analysis of patients with thymomas undergoing modified maximal thymectomy over a period of 16 ye...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0097-0
更新日期:2009-08-01 00:00:00
abstract::It is a fundamental clinical observation that wounds do not heal in tissue that does not bleed, and they almost always heal in tissue that bleeds extensively. Continuous supply of oxygen to the tissue through microcirculation is vital for the healing process and for resistance to infection. Evaluation of tissue perfus...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7398-5
更新日期:2004-03-01 00:00:00
abstract::Sixty-one patients who were diagnosed with mucosal gastric cancer have been successfully treated with two laparoscopic techniques at our institute from March 1992 to March 1997. One is laparoscopic wedge resection of the stomach using a lesion-lifting method for lesions of the anterior wall, the lesser curvature, and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013167
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS:This was a 4-year ret...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4338-3
更新日期:2018-06-01 00:00:00
abstract::Mesosigmoidoplasty is a nonresective procedure for nongangrenous sigmoid volvulus. It aims to correct the main pathogenetic factor of this condition, the narrow but long mesosigmoid. Although it had been demonstrated by intraoperative measurements that this has indeed achieved its purpose, recurrent volvulus has been ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7010-z
更新日期:2003-12-01 00:00:00
abstract::The previous finding of an increased risk of premature death in a consecutive series of 896 patients operated on for primary hyperparathyroidism between 1953 and 1982 [1] raised the question of the role that surgery plays in relation to the risk of death. In the present study, undertaken to examine that issue, 3 facto...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658740
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Although multidetector-row computed tomography (MDCT) before biliary drainage is useful for the assessment of the resectability of perihilar cholangiocarcinoma (PHC), the impact of biliary drainage on MDCT images before surgical resection for PHC has been poorly studied, and its possible consequences for R0 ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4654-2
更新日期:2018-11-01 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:BACKGROUND:Primary hyperparathyroidism (HPT) is often caused by a benign parathyroid tumor, adenoma; less commonly by multiglandular parathyroid disease/hyperplasia; and rarely by parathyroid carcinoma. Patients with multiple tumors require wider exploration to avoid recurrence and have increased risk for hereditary di...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-009-0022-6
更新日期:2009-11-01 00:00:00
abstract::A variety of techniques have been used for surgical treatment of hepatic hydatid cysts. The objective of this study is to describe the technique of diaphragm myoplasty, and to present our experience in the treatment of selected patients with hydatid disease of the liver by means of this alternative surgical technique....
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6558-3
更新日期:2003-02-01 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:BACKGROUND:The number of lymph nodes retrieved and examined from a resected colon cancer specimen may be crucial for correct staging. We examined if efforts to increase the lymph node harvest to more than 12 lymph nodes per specimen would upstage some patients from TNM stage II to III. METHODS:Three hospitals compared...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00268-011-1248-7
更新日期:2011-12-01 00:00:00
abstract::We have previously demonstrated that in 95.6% of malignant thyroid tumors the enzyme thyroid peroxidase (TPO) presents antigenic changes detectable by a monoclonal antibody termed MoAb47. The aim of this study was to investigate the interest of TPO immunodetection for the diagnosis of malignancy on fine-needle aspirat...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/BF00353756
更新日期:1994-07-01 00:00:00
abstract::Surgical exposure of the recurrent laryngeal nerve decreases the incidence of nerve injuries during thyroid surgery. Intraoperative neuromonitoring was introduced to facilitate identification and protection of the recurrent laryngeal nerve. Between February 1996 and June 2002 a total of 288 patients underwent thyroid ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7226-6
更新日期:2004-06-01 00:00:00
abstract::Node dissection for melanoma remains the most important therapeutic decision for the optimal management of the patient with melanoma. In Australia and in some parts of the United States, the majority of patients with intermediate thickness melanoma (1.6-4.00 mm) will undergo elective lymph node dissection. In Europe, ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Critical limb ischemia (CLI) caused by peripheral arterial disease is associated with significant morbidity and mortality. This condition is associated with a 30 % amputation rate as well as mortality levels which might be as high as 25 %. There is no pharmacological therapy available, but several reports ha...
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:INTRODUCTION:Rectus sheath hematoma is rare. It can present to physicians in many specialties, but invariably the surgeon is contacted regarding management. It is frequently difficult to diagnose, which can result in delay of treatment or unnecessary surgery. Its incidence is on the rise. METHODS:We present a series o...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0702-9
更新日期:2006-11-01 00:00:00
abstract::Video-assisted thyroidectomy, although an increasingly used method to treat benign thyroid nodules, is rarely used to treat thyroid cancer. We performed gasless video-assisted total thyroidectomy for the treatment of papillary carcinoma of the thyroid. The patients were two men and five women with ages ranging from 29...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7446-9
更新日期:2004-09-01 00:00:00
abstract::The purpose of this study was to elucidate the function of the sphincter of Oddi (SO) in patients with juxtapapillary duodenal diverticula (JDDs). The SO function was evaluated by intraoperative biliary manometry in three groups of patients. Group 1 consisted of nine patients with JDDs and a dilated common bile duct (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00308647
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:There is a paucity of data on the presentation and surgical management of pheochromocytoma in developing nations, particularly in Africa. METHODS:This study was a retrospective review, which included all patients managed by the Groote Schuur Hospital/University of Cape Town Endocrine Surgery unit for pheoch...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05420-6
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Surgical site infection (SSI) is a common cause of major morbidity after liver resection. This study aimed to identify the risk factors for incisional and organ/space SSIs after liver resection. METHODS:Our liver surgery database was retrospectively analyzed for patients treated between January 2009 and Nov...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2922-3
更新日期:2015-05-01 00:00:00
abstract::A large number of families with familial isolated hyperparathyroidism (FIHP) have been reported. We wanted to determine if some of these families represent early manifestations of full-blown syndromes such as multiple endocrine neoplasia type 1 (MEN-1), as early identification may alter surgical and medical management...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6617-9
更新日期:2002-08-01 00:00:00
abstract:INTRODUCTION:The role for diverting ostomy as a method to help reduce morbidity and mortality has been well established in the combat trauma population. However, factors that influence the type of ostomy used and which ostomies become permanent are poorly studied. We examine patterns of ostomy usage and reversal in a l...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4759-7
更新日期:2019-01-01 00:00:00