The role of transcervical thymectomy in patients with hyperparathyroidism.
*Thymectomy/methods; Adult; Aged; Female; Humans; Hyperparathyroidism/etiology/pathology/*surgery; Hypocalcemia/etiology; Male; Middle Aged; Parathyroidectomy; Postoperative Complications; Retrospective Studies; Thymus Gland/pathology/surgery; Treatment Outcome
BACKGROUND: The most common location for supernumerary or ectopic parathyroid glands is the thymus. METHODS: A review of patients who underwent parathyroidectomy for hyperparathyroidism from 1990 to 2010 was completed to determine indications for thymectomy, the yield of parathyroid tissue, and outcome of therapy. RESULTS: Seventy of 379 patients with hyperparathyroidism underwent parathyroidectomy and transcervical thymectomy. Intrathymic parathyroid tissue was present in 23 (33%) patients, including supernumerary glands in 8 patients (11%). Indications for thymectomy were renal hyperparathyroidism in 35 patients (50%) and primary hyperparathyroidism with a missing inferior gland in 20 patients (29%), an ectopic adenoma in 9 patients (13%), hyperplasia in 5 patients (7%), and carcinoma in 1 patient (1%). Cure rates were similar (96% and 98%; P = not significant) and only transient hypocalcemia was higher (51% vs 24%, P \textless .05) after parathyroidectomy with thymectomy versus parathyroidectomy alone. CONCLUSIONS: Transcervical thymectomy results in a high yield of parathyroid tissue and is essential for cure of selected patients with hyperparathyroidism.
Welch Kellen; McHenry Christopher R
American journal of surgery
2012
2012-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.amjsurg.2011.09.013" target="_blank" rel="noreferrer noopener">10.1016/j.amjsurg.2011.09.013</a>
Selective lateral compartment neck dissection for thyroid cancer.
80 and over; Adenocarcinoma; Adult; Aged; Carcinoma; Female; Follicular/mortality/secondary/surgery; Follow-Up Studies; Humans; Local/mortality/pathology/surgery; Lymph Node Excision/*methods; Lymph Nodes/anatomy & histology/surgery; Lymphatic Metastasis; Male; Medullary/mortality/secondary/*surgery; Middle Aged; Morbidity; Neck Dissection/*methods; Neck Muscles/anatomy & histology/surgery; Neoplasm Recurrence; Papillary/mortality/secondary/surgery; Retrospective Studies; Selective lateral compartment neck dissection; Thyroid cancer; Thyroid Neoplasms/mortality/pathology/*surgery; Thyroidectomy/*methods; Young Adult
BACKGROUND: Compartment-oriented lymph node dissection in patients with thyroid cancer and macroscopic lymph node metastases reduces recurrence and improves survival. However, the extent of lymph node dissection remains controversial. The purpose of this study was to examine the results of selective lateral compartment neck dissection (LCND) for thyroid cancer. METHODS: We completed a retrospective review of patients with thyroid cancer who underwent selective LCND from
Welch Kellen; McHenry Christopher R
The Journal of surgical research
2013
2013-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jss.2013.04.084" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2013.04.084</a>
Delayed intracranial hemorrhage in elderly anticoagulated patients sustaining a minor fall.
*Delayed intracranial hemorrhage; *Elderly; *Fall; *Head injury; *Intracranial hemorrhage; 80 and over; Accidental Falls/*statistics & numerical data; Aged; Anticoagulants/administration & dosage/*adverse effects; Combination; Drug Therapy; Female; Humans; Intracranial Hemorrhages/diagnostic imaging/*etiology; Male; Platelet Aggregation Inhibitors/administration & dosage/*adverse effects; Retrospective Studies; Tomography; X-Ray Computed
BACKGROUND: Falls are a common cause of hospitalization, morbidity, and mortality among the elderly in the United States. Evidence-based imaging recommendations for evaluation of delayed intracranial hemorrhage (DICH) are not generally agreed upon. The purpose of this project was to evaluate the incidence of DICH detected by head computer tomography (CT) among an elderly population on pre-injury anticoagulant or antiplatelet (ACAP) therapy. METHODS: Data from a Level 1 Trauma Center trauma registry was used to assess the incidence of DICH in an elderly population of patients (\textgreater/=65 years) who sustained a minor fall while on pre-injury ACAP medications. Counts and percentages are reported. RESULTS: Data on 1076 elderly trauma patients were downloaded, of which 838 sustained a minor fall and 513 were found to be using a pre-injury ACAP medication. One patient (0.46%) with a DICH was identified out of 218 patients who received a routine repeat head CT. Aspirin and warfarin were the most common pre-injury ACAP medications and 19.27% (42/218) of patients were found to be using multiple ACAP medications. CONCLUSIONS: Universal screening protocols promote immediate-term patient safety, but do so at a great expense with respect to health expenditures and increased radiation exposure. This analysis highlights the need for an effective risk assessment tool for DICH that would reduce the burden of unnecessary screenings while still identifying life-threatening intracranial hemorrhages in affected patients.
Mann Nolan; Welch Kellen; Martin Andrew; Subichin Michael; Wietecha Katherine; Birmingham Lauren E; Marchand Tiffany D; George Richard L
BMC emergency medicine
2018
2018-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s12873-018-0179-0" target="_blank" rel="noreferrer noopener">10.1186/s12873-018-0179-0</a>