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At least 109 records · Page 6Linked to original sources
PubMed2006

How we do it: Changes in thyroid and salivary gland surgery since 1989: who's doing it and what are they doing?

Keypoints * The aim of this study was to identify changes in the provision of parotid, submandibular and thyroid gland surgery between surgical specialties since 1989, as well as changes in surgical practice. * Data from the Department of Health's Hospital Episode Statistics (HES) was extracted from 1989/1990 and 2003/2004 records by operation and surgical specialty in England. * The data reveals a considerable decline in the amount of parotid and submandibular surgery performed by General surgeons; with the majority of this surgery currently being performed by ENT surgeons, and to a lesser extent, Oral and Maxillo-Facial surgeons. * Thyroid surgery has undergone less radical change, with General surgeons continuing to perform the majority of cases; however, an increasing proportion is now provided by ENT surgeons. * There also seems to be changes in the types of thyroid operation being performed; with large increases in total thyroidectomy and reductions in subtotal thyroidectomies.

Data Collection↗
PubMed2006

International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas.

Non-inflammatory cystic lesions of the pancreas are increasingly recognized. Two distinct entities have been defined, i.e., intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN). Ovarian-type stroma has been proposed as a requisite to distinguish MCN from IPMN. Some other distinct features to characterize IPMN and MCN have been identified, but there remain ambiguities between the two diseases. In view of the increasing frequency with which these neoplasms are being diagnosed worldwide, it would be helpful for physicians managing patients with cystic neoplasms of the pancreas to have guidelines for the diagnosis and treatment of IPMN and MCN. The proposed guidelines represent a consensus of the working group of the International Association of Pancreatology.

Endocrine Surgical Procedures↗
PubMedDate not supplied

Determining when to operate on patients with Hashimoto's thyroiditis with nodular lesions: the role of ultrasound-guided fine needle aspiration cytology.

OBJECTIVE: To elucidate the role of ultrasound-guided fine needle aspiration cytology (FNAC) in determining whether to request an operation. STUDY DESIGN: Twenty-four consecutive patients (23 women and 1 man) with Hashimoto's thyroiditis combined with nodular lesions revealed by ultrasonography were included in the study. Ultrasound-guided FNAC was performed on their thyroid tissue compatible with Hashimoto's thyroiditis and nodular lesions. RESULTS: Two of 24 patients (8.3%) had papillary thyroid cancer, which was diagnosed from aspirates of 31 nodular lesions and confirmed by operative pathologic findings. CONCLUSION: If a patient with Hashimoto's thyroiditis has nodular lesions shown by ultrasonography, ultrasound-guided FNAC is helpful in elucidating the nature of the lesion and determining whether to request an operation.

Adult↗
PubMed2001

Factors associated with perioperative morbidity and mortality in patients with pheochromocytoma: analysis of 165 operations at a single center.

To identify preoperative factors associated with 30-day morbidity and mortality after pheochromocytoma surgery, we carried out an external review of the records of all patients undergoing pheochromocytoma surgery from 1975 to 1997 at a single center. One hundred and forty-seven patients, including 23 with malignant tumors at the time of the first operation, underwent 165 operations. Death, resection of a neighboring organ, further surgery, secondary transfer to an intensive care unit, and any events associated with a surgical stay exceeding 10 days were defined as complications. Mortality and morbidity were 4 of 165 (2.4%) and 38 of 161 (23.6%), respectively. Morbidity included 13 spleen resections and hematomas. Spleen complications were not related to tumor location, but were probably due to the operative strategy used, a transperitoneal complete abdominal exploration including both adrenal glands. Complications were independently associated with preoperative systolic blood pressure [odds ratio (OR), 1.14/cm Hg], urinary metanephrine excretion (OR, 1.18/10 micromol x day), and with the number of operations (repeat vs. first operation OR, 5.36). In conclusion, pheochromocytoma resection consistently involves a risk of complications. Spleen damage should be prevented by complete preoperative localization studies and an elective or laparoscopic surgical approach. Careful blood pressure control should help prevent complications. Patients with high secretion tumors and those undergoing repeat intervention are at high risk of complications and should be referred to centers familiar with pheochromocytoma management.

Adolescent↗