Surgery
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In papillary thyroid microcarcinoma (PTMC), regional lymph node metastasis (LNM) is associated with a increased locoregional recurrence rate. Yet, prophylactic central lymph node dissection (CLND) targeting subclinical central LNM continues to be a matter of debate in the treatment of PTMC, which generally carries an excellent prognosis. The aim of our study was to investigate the benefits and risks of prophylactic CLND in patients with clinically node-negative PTMC. ⋯ With prophylactic CLND, the postoperative Tg level can significantly decrease. However, prophylactic CLND is not helpful in decreasing short-term locoregional recurrence in patients with clinically node-negative PTMC. Finally, the risk of permanent hypocalcemia may increase after CLND.
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Comparative Study
Outcomes of elective abdominal aortic aneurysm repair among the elderly: endovascular versus open repair.
National outcomes for elective abdominal aortic aneurysm (AAA) repair in elderly populations are needed. The purpose of this study was to analyze outcomes of endovascular (EVAR) and open surgical repair (OSR) of elective AAA among the elderly (≥80 years). ⋯ Although elderly patients have worse outcomes compared with younger patients regardless of approach, endovascular repair among elderly patients is associated with less morbidity and mortality compared with open repair.
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Comparative Study
Morphologic changes and prognosis of the respiratory tract epithelium in inhalation injury and their relationship with clinical manifestations.
We set out to observe the morphologic changes and determine prognosis based on airway epithelial injury after inhalation injury of varying severity using a fiberbronchoscope and to explore the relationship between the severity of epithelial injury and its clinical manifestation. ⋯ Fiberoptic bronchoscopy contributes to the accurate evaluation of tracheal epithelial injury severity. As the severity of inhalation injury increased, the clinical symptoms also increased. Severe complications (eg, bleeding and asphyxia caused by epithelial slough) may occur in patients with third-degree injury and should be closely observed by clinicians. The airway epithelium has a substantial potential for repair. Even if the airway epithelial injury is severe, the damaged epithelium will recover.
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Nationwide rates and patterns of death after surgery are unknown. ⋯ Nationwide reporting on surgical mortality suggests that the number of inpatient deaths within 30 days of surgery has declined. Additional research to determine the underlying causes for decreased mortality is warranted.