Abstract：
BACKGROUND:The purpose of this study was to describe the incidence and clinical/pathologic characteristics of papillary thyroid microcarcinoma (PMC) in a community hospital setting and to evaluate the frequency and characteristics of these lesions when unsuspected preoperatively. METHODS:A total of 723 patients underwent a partial or total thyroidectomy. A retrospective review was performed. RESULTS:A total of 194 of the 723 patients had a final diagnosis of papillary carcinoma. Ninety-six (49%) of these tumors were PMCs defined as being 1.0 cm or less in diameter. One third (32 of 96) of these lesions were multifocal and 16.7% (16 of 96) were found to have regional lymph node metastases. The majority (58%) of PMCs were found on final pathology and were clinically unsuspected (occult). Multifocality was found in 32.1% (18 of 56) of patients with clinically unsuspected PMC, with nodal metastases in 3.6% (2 of 56). The other 40 patients with PMC had surgeries performed for a clinical reason related to that pathologic lesion. This clinically suspected group was comparably multifocal (35%), but more likely to have cervical lymph node metastasis (35%). Sixty-six percent (37 of 56) diagnosed with a clinically unsuspected PMC underwent a partial thyroidectomy at the initial surgery. CONCLUSIONS:The prevalence of clinically unsuspected PMC in our population undergoing thyroidectomy was 7.7% (56 of 723). In our institution, this is more than half of all PMCs. The incidence of cervical lymph node metastasis in clinically unsuspected PMC was only 3.6% compared with 35% in clinically suspected disease, suggesting that the biological behavior (and possibly treatment) may be different. Long-term follow-up evaluation is needed to better evaluate the significance of these differences.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Dunki-Jacobs E,Grannan K,McDonough S,Engel AMdoi
10.1016/j.amjsurg.2010.12.008subject
Has Abstractpub_date
2012-02-01 00:00:00pages
140-4issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00207-8journal_volume
203pub_type
杂志文章abstract：:The dual tracer nuclear scintiscan using technetium and thallium to localize enlarged or ectopic parathyroid tissue has been reported to be highly accurate and efficacious. Fourteen previous series reporting results of the technique have been compiled from the literature and analyzed. This analysis has revealed a tota...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90798-7
更新日期：1987-05-01 00:00:00
abstract：:Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80049-0
更新日期：1985-04-01 00:00:00
abstract：:A 5 year experience of 248 patients with isolated penetrating lower chest injury was reviewed. Twenty-two (15 percent) of the stab wounds and 46 (46 percent) of the gunshot wounds caused associated intraabdominal injury. Among those taken to the operating room for laparotomy, physical examination proved misleading in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90104-x
更新日期：1980-12-01 00:00:00
abstract：BACKGROUND:Response evaluation criteria in solid tumors (RECIST) is the accepted method for determining tumor progression. However, RECIST may not estimate disease burden accurately because the axial plane often does not produce the actual longest diameter. Volumetric measurements may be an alternative to better determ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.007
更新日期：2012-11-01 00:00:00
abstract：OBJECTIVE:We incorporated a hybrid-abdominal wound simulation to teach/assess the acquisition of three essential clinical skills in the ACS/ASE Medical Student Simulation-based Surgical Skills Curriculum. METHOD:Third year students (N = 43) attended a workshop based on the ACS/ASE surgical skills curriculum for drain ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.039
更新日期：2019-02-01 00:00:00
abstract：:Hemorrhage is a major cause of trauma deaths. Coagulopathy exacerbates hemorrhage and is commonly seen during major trauma resuscitation, suggesting that current practice of coagulation factor transfusion is inadequate. Reversal of coagulopathy involves normalization of body temperature, elimination of the causes of d...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.03.034
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:There is a significant incidence of unrecognized postextubation dysphagia in trauma patients. The purpose of this study was to evaluate the incidence, ascertain the risk factors, and identify patients with postextubation dysphagia who will require clinical swallow evaluation. METHODS:A prospective observati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.010
更新日期：2013-12-01 00:00:00
abstract：:Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90142-3
更新日期：1983-06-01 00:00:00
abstract：:A case of unicystic ameloblastoma of the mandible in a 10-year-old child is described. In addition to the mandibular swelling the patient also had a proliferative lesion over the alveolus that masqueraded as a neoplastic lesion. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.036
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:In about 30% of patients, chronic pancreatitis leads to an inflammatory enlargement of the pancreatic head with subsequent obstruction of the pancreatic duct, common bile duct, and duodenum. METHODS:In a prospective, randomized controlled trial, we compared duodenum-preserving pancreatic head resection (DPP...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(99)80111-1
更新日期：1995-01-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS:A briefing score (1, never started; 2, started then discontinued; 3, maintained on original ta...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.011
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Perihilar cholangiocarcinoma is usually unresectable at the time of diagnosis. Only few patients are candidates for a potential curative treatment. For those patients, prognosis is strongly related to negative resection margin and lymph node status. Thus, a certain benchmark of lymph node count is necessary ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2015.05.015
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:The objective of this study was to investigate whether the preoperative hematologic markers, the platelet-lymphocyte ratio (PLR), or the neutrophil-lymphocyte ratio (NLR) ratio are significant prognostic indicators in resected pancreatic ductal adenocarcinoma. METHODS:A total of 84 patients undergoing pancr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.041
更新日期：2010-08-01 00:00:00
abstract：BACKGROUND:Surgery is a vital component of a comprehensive health system, but there are often personnel limitations in resource constrained areas. Zambia provides post graduate surgical training through two systems to help address this shortage. However, no studies have analyzed surgical trainees' perceptions of these ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.07.023
更新日期：2018-04-01 00:00:00
abstract：:Despite the advantages of aseptic nonoperative intubation of the small intestine for decompression of obstructed loops, 48% of the attempts lead to failure to pass the tube through the pylorus. The difficulty and inconvenience of passage beyond the stomach have been overcome by the development of a special tube attach...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90427-x
更新日期：1976-01-01 00:00:00
abstract：:Survival rates after liver transplantation continue to improve, but the postoperative morbidity in these patients remains significant. The clinical courses of 96 consecutive patients who received transplants were reviewed retrospectively. Forty-two patients experienced complications requiring surgical intervention. Th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80542-7
更新日期：1988-12-01 00:00:00
abstract：:Lasers have been used for endoscopic gastrointestinal surgery at our institution since 1977. The argon and Nd-YAG lasers are valuable for coagulating upper gastrointestinal hemorrhage, arteriovenous malformations, and benign and malignant lesions, as well as a variety of anatomic anomalies. Between December 1977 and S...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90427-6
更新日期：1984-12-01 00:00:00
abstract：:The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) has major implications for the future of carotid revascularization and stroke prevention. The purpose of The William Hinter Harridge Lecture was to discuss the history of carotid revascularization before CREST, to delineate the emergence of car...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.02.001
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:The efficacy of carotid endarterectomy (CEA) in octogenarians is controversial. Recent reports have examined this question in the general population, but little data exist on veterans. With the emergence of carotid artery stenting, we need to evaluate the role of CEA in treating elderly veterans with carotid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.07.022
更新日期：2005-11-01 00:00:00
abstract：BACKGROUND:Achieving a higher hemoglobin (Hb) level might allow the anemic, critically ill, trauma patient to have an improved outcome during rehabilitation therapy. METHODS:Patients with major blunt trauma orthopedic injuries were administered epoetin alfa or placebo weekly both in hospital and for up to 12 weeks aft...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.amjsurg.2011.08.006
更新日期：2012-04-01 00:00:00
abstract：:In this study, we sought to identify changes in the picture of a selected surgical condition during an interval of time that has brought about radical departures from previously established policies and programs. As a direct consequence, the patients take a more circuitous route to the surgeon. A significant number of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90549-7
更新日期：1989-03-01 00:00:00
abstract：:Wounds will readily acquire bacteria, unless protective measures are taken. The bacterial protection afforded by conventional absorbent cellulose dressings has been shown to be limited, particularly in the presence of serous exudate that may compromise dressing integrity. In addition, dressings may shed particles that...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(94)90006-x
更新日期：1994-01-01 00:00:00
abstract：:Of six healthy laboratory workers with no history of illness caused by Pseudomonas aeruginosa, four exhibited positive skin responses at 24 hours, strong inhibition of leukocyte migration, and marked stimulation of blastogenesis of peripheral lymphocytes when exposed to a "cocktail" of three phenol-killed strains of P...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90160-x
更新日期：1977-06-01 00:00:00
abstract：:A safe and rapid technic for internal jugular vein cannulation is described. The success rate is almost as high and the serious complication rate is much lower than subclavian vein cannulation. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90148-4
更新日期：1978-05-01 00:00:00
abstract：:As discussed by Urschel [13], 50 to 70 percent of patients with symptoms of thoracic outlet syndrome may be treated conservatively by nonsurgical methods. Patients who still have symptoms after years of such therapy are referred to us for surgical treatment. Failure to obtain symptomatic relief after scalenotomy alone...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90351-7
更新日期：1980-05-01 00:00:00
abstract：:Hypersplenism was not relieved by distal splenorenal shunting in 46 of 47 Japanese patients with nonalcoholic cirrhosis of the liver. However, the platelet count significantly increased by 40 percent of the preoperative value, whereas the increment in the white blood cell count was nil. Though the platelet count in 47...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80164-8
更新日期：1988-07-01 00:00:00
abstract：BACKGROUND:Prior studies have demonstrated that African-American (AA) donor kidneys are independently associated with an increased risk for graft loss. METHODS:We examined outcomes in comparable groups of AA deceased-donor (DD) kidney transplant patients receiving an AA donor (n=35) versus a Caucasian donor (C group; ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.025
更新日期：2010-03-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine if the distance from the skin to the seroma cavity, as measured with ultrasound (US) before catheter placement, correlated with the distance from skin to MammoSite balloon catheter as measured on computerized axial tomography (CAT) after catheter placement. METHODS:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.11.012
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND:In view of the indolent nature of most cancers of the thyroid, particularly of the papillary and follicular variety, the decision to remove a segment of the upper aerodigestive tract when the cancer is either close to or invading this area is a difficult one. It was felt relevant to review the experience at ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80136-9
更新日期：1994-12-01 00:00:00
abstract：:We believe that paragangliomas of the carotid body should be excised in all patients unless formidable medical conditions prohibit the use of general anesthesia. If these tumors are left unresected, they will eventually grow to invade the skull and kill the patient. With definitive diagnostic modalities available, in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90052-1
更新日期：1983-04-01 00:00:00
