World Journal of Surgery最新文献

{"title":"Current landscape of minimally invasive pancreatectomy for neoplasms: A retrospective cohort study.","authors":"Rejoice F Ngongoni, Busisiwe Mlambo, I-Fan Shih, Yanli Li, Sherry M Wren","doi":"10.1002/wjs.12408","DOIUrl":"https://doi.org/10.1002/wjs.12408","url":null,"abstract":"<p><strong>Background: </strong>To evaluate recent minimally invasive pancreatectomy (MIP) trends for neoplastic disease and compare perioperative outcomes.</p><p><strong>Methods: </strong>Patients who underwent open (OS) or MIP (laparoscopic-LS or robotic-RS) pancreaticoduodenectomy (PD) or non-pancreati-coduodenectomy resections (non-PD) were identified from PINC AI Healthcare Database. Outcomes were compared using multivariable regressions.</p><p><strong>Results: </strong>OS was the predominant approach for PD (87.8%); MIP was more common in non-PD (48.5%) than PD with a substantial RS uptake (11.7%-29.9%). In PDs, outcomes were similar except OS had a longer length of stay (LOS) and lower costs. In non-PDs, MIP patients were less likely to have prolonged LOS, intensive care unit admission, and overall complications than OS. Conversion to OS was lower in the RS approach than LS in PD and non-PD.</p><p><strong>Conclusions: </strong>MIP for non-PD has become the most common operative approach with improved outcomes; MIP-PD has flat adoption and similar outcomes to OS. Robotics facilitates MIP (PD and non-PD) completion through fewer conversions to open surgery (OS).</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omission of lymph node dissection along the recurrent laryngeal nerve for lower thoracic esophageal squamous cell carcinoma with short esophageal invasion.","authors":"Yasufumi Koterazawa, Hironobu Goto, Hiroshi Saiga, Yuki Azumi, Ryuichiro Sawada, Hitoshi Harada, Naoki Urakawa, Hiroshi Hasegawa, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Yoshihiro Kakeji","doi":"10.1002/wjs.12427","DOIUrl":"https://doi.org/10.1002/wjs.12427","url":null,"abstract":"<p><strong>Background: </strong>Esophagectomy with lymphadenectomy is the primary treatment for esophageal squamous cell carcinoma (ESCC). However, intensive dissection of lymph nodes (LNs) along the recurrent laryngeal nerve (RLN) is associated with RLN palsy and pulmonary complications leading to poor survival. Therefore, this study aimed identify the risk factors for LNs metastasis along the RLN in patients with ESCC.</p><p><strong>Methods: </strong>The present study included 168 patients with lower thoracic esophageal and esophagogastric junction (EGJ) squamous cell carcinoma who underwent esophagectomy with total mediastinal lymphadenectomy at Kobe University Hospital. Left/Right cervical paraesophageal (101 L/R), left/right recurrent nerve (106 recL/R), and left tracheobronchial LNs (106 tbL) were defined as LNs along the RLN. We evaluated the pathological distance between the proximal tumor boundary and the EGJ using images of the fixed specimen (PB-EGJ length).</p><p><strong>Results: </strong>LN metastasis along the RLN was observed in 19 (11%) patients. The percentage of patients with a longer PB-EGJ length and cLNs metastasis was higher in the LNs metastasis along the RLN positive-group than in the RLN-negative group (p = 0.0075 and p = 0.013, respectively). The incidence of LNs metastasis along the RLN was 0% (95% confidence interval [CI] = 0-7.7%) when the PB-EGJ length was <4 cm. Univariate analysis showed that patients with cLNs metastasis negative had a low risk for LNs metastasis along the RLN (odds ratio = 0.26 and 95% CI = 0.083-0.82).</p><p><strong>Conclusions: </strong>Patients with a PB-EGJ length <4 cm and negative for cLNs metastasis may be candidates for the omission of lymphadenectomy along the RLN.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-radical gastrectomy long-term survival and etiologies of mortalities in older adult patients greater than 80 years of age with gastric cancer.","authors":"Ryota Matsui, Souya Nunobe, Motonari Ri, Rie Makuuchi, Tomoyuki Irino, Masaru Hayami, Manabu Ohashi, Takeshi Sano","doi":"10.1002/wjs.12405","DOIUrl":"https://doi.org/10.1002/wjs.12405","url":null,"abstract":"<p><strong>Background: </strong>Patients aged >80-years-old with gastric cancer are commonly excluded from clinical trials, and no consensus exists regarding surgical indications and outcomes in older patients. In this study, we analyzed the post-gastrectomy long-term survival and etiologies of mortality in older patients with gastric cancer.</p><p><strong>Methods: </strong>Patients aged >80-years-old with pathological stages I-III primary gastric cancer who undergone radical gastrectomies, between May 2006 and March 2017, were included in the study. Eligible patients were categorized into 3 age cohorts: <85-, 85-90-, and >90-years-old. The primary outcome was the overall survival. The etiologies of mortalities were compared. Survival curves were compared using the log-rank test. Prognostic factors were identified by multivariate analysis, using the Cox proportional hazards regression model.</p><p><strong>Results: </strong>The median follow-up duration was 59 months. Of the 353 patients, 269 (76.2%), 71 (20.1%), and 13 (3.7%) were categorized into the <85-, 85-90-, >90-years-old age cohorts, respectively. Older patients had a poorer overall survival (p = 0.003) and statistically significant difference in the other-cause survival (p < 0.001). The multivariate analysis revealed that age was not an independent prognostic factor for overall or cancer-specific survival. However, an age >90-years-old was an independent prognostic factor for the other-cause survival.</p><p><strong>Conclusions: </strong>In patients aged >80-years-old with gastric cancer who had undergone gastrectomies, mortalities from other diseases increased with age; while mortalities from gastric cancer did not. An age of ≥90-years-old was an independent prognostic factor for mortalities from other diseases.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding and secretory factors in idiopathic granulomatous mastitis: Unveiling etiological insights.","authors":"Kenan Çetin","doi":"10.1002/wjs.12426","DOIUrl":"https://doi.org/10.1002/wjs.12426","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic granulomatous mastitis (IGM) is a rare, chronic inflammatory, and benign breast disease. Its unclear etiology may involve autoimmune reactions, secretion-related factors, and microorganisms.</p><p><strong>Aim: </strong>To analyze data from our IGM patient series and compare potential etiological factors.</p><p><strong>Methods: </strong>We prospectively collected data using follow-up forms for patients diagnosed with IGM at our breast clinic from September 2014 to December 2020 and analyzed it retrospectively.</p><p><strong>Results: </strong>The study cohort included 220 patients, with a median age of 34 years (range: 20-58). A majority, 217 patients (98.6%), reported a history of breastfeeding, with a median duration of 36 months (range: 0-156). The median interval between the last breastfeeding session and disease onset was 25 (25th-75th percentiles: 15-44) months. Additionally, 116 patients (53.5%) reported breastfeeding-related problems. In 41 surgical patients, dense milky-brown debris in the breast ducts was noted. Although no independent seasonal fluctuations in disease onset were detected, a reduction in IGM cases during the summer months was found to correlate with a general decrease in all breast clinic visits.</p><p><strong>Conclusion: </strong>Most patients reported recent breastfeeding and half experienced related problems, supporting the secretion theory's relevance in IGM's etiology. The absence of seasonal fluctuations suggests that secretion-related factors may be more central to IGM development than autoimmunity or infections. These findings offer crucial insights for future research into IGM's complex causes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply: Enhanced recovery after surgery and intestinal obstruction: A scoping review.","authors":"Marie Sin Ae Buhl, Claudia Jaensch, Anders Husted Madsen","doi":"10.1002/wjs.12406","DOIUrl":"https://doi.org/10.1002/wjs.12406","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes following the resection of screen-detected right-sided colon cancer.","authors":"James Lucocq, Thomas Trinder, Elli Symeonidou, Katy Homyer, Hassan Baig, Pradeep Patil, Girivasan Muthukumarasamy","doi":"10.1002/wjs.12409","DOIUrl":"https://doi.org/10.1002/wjs.12409","url":null,"abstract":"<p><strong>Background: </strong>The relative outcomes following the resection of screen-detected right-sided colon cancer compared to symptomatic cases are unknown. In this study, short and long-term outcomes after right-sided colectomy in screen-detected colon cancer are compared with symptomatic cases, both emergency and elective.</p><p><strong>Methods: </strong>A prospective observational cohort study of patients, including both screen-detected and symptomatic patients (elective and emergency resections), undergoing right-sided colectomy for colon cancer (2010-2020) in a tertiary care unit was conducted. Each patient was followed up for long-term recurrence and survival.</p><p><strong>Results: </strong>A total of 909 patients (median age, 70; IQR, 58-82; male, 52%) were included (151 patients (16.6%) screen-detected; 598 (65.8%) elective and 160 (17.6%) emergency). Screen-detected patients were more likely to have T1 or T2 lesions compared to elective and emergency groups (T1: 14.6% vs. 3.8% vs. 0.6% p < 0.001; T2: 16.6% vs. 8.9% vs. 3.1% p < 0.001), but were less likely to have T3 or T4 lesions (p < 0.001), respectively. Rates of N0 were higher in the screen-detected group (68.9% vs. 63.5% vs. 41.9%, respectively; p < 0.001). 98% of the screen-detected group achieved R0 resection compared to 93.3% of elective and 79.4% of emergency patients (p < 0.001). At 5-years following resection, overall survival for the screen-detected, elective, and emergency groups were 85.4%, 75.4%, and 53.1%, respectively (p < 0.001). Recurrence at 5-year post-resection were 8%, 15.1%, and 22.5% for the screen-detected, elective, and emergency groups, respectively (p < 0.001).</p><p><strong>Discussion: </strong>When considering right-sided colon cancer alone, screen-detected cancers have a lower long-term recurrence rate, lower rates of postoperative complication, and superior survival compared to symptomatic groups following resection.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with elective surgical case cancellation at a tertiary hospital in Malawi.","authors":"Paul Serrato, Vanessa Msosa, Jephta Kondwani, Mwai Nkhumbwah, Hani Mowafi, Jonathan P Smith, Gift Mulima, Melanie Sion","doi":"10.1002/wjs.12404","DOIUrl":"10.1002/wjs.12404","url":null,"abstract":"<p><strong>Background: </strong>Same-day cancellation of surgery affects up to 44% of cases at a public tertiary hospital in Lilongwe, Malawi. To characterize these cancellations, this study examines surgical volume, cancellation causes, and surgery completion rate after initial cancellation, which are not otherwise monitored for analysis in this setting.</p><p><strong>Methods: </strong>We conducted a serial cross-sectional study at the Kamuzu Central Hospital (KCH) during a 6 month period. Variables included patient demographics, procedure information, and hospital capacity factors. Bivariate and multivariable regression models were constructed to assess factors associated with cancellation.</p><p><strong>Results: </strong>Of the 3121 total surgeries, 2626 (84.1%) were elective procedures, of which 747 (28.4%) were canceled. Orthopedic surgery observed the highest cancellation rate (36.5%). Process-related factors, such as starting cases late, were the primary reason for cancellation (64.3%). Only 40% of patients with a canceled surgery underwent their procedure after index admission, with a median wait time of 3 days. Emergency cases (aOR: 0.50 and CI: 0.39 and 0.64) and first cases of the day (aOR: 0.02 and CI: 0.01 and 0.04) were associated with lower odds of cancellation. Facility factors associated with lower odds of cancellation included number of open operating rooms (OR: 0.86 and CI: 0.77 and 0.96) and anesthetists assigned on duty (OR: 0.94 and CI: 0.88 and 0.99).</p><p><strong>Conclusion: </strong>Cancellation of elective surgery was primarily driven by process-related factors. We identify facility-related factors associated with lower odds of cancellation and thus provide targets for future interventions at KCH. Studies examining patient outcomes following elective case cancellation are warranted as most patients never return for surgery following cancellation.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of unilateral-cannulating adrenal venous sampling for the subtyping of primary aldosteronism for adrenalectomy: Experience from a low-volume center.","authors":"Chi-Man Tom Chow, Man Sze Carol Lai, Xina Lo, Yuk Wah Shirley Liu","doi":"10.1002/wjs.12402","DOIUrl":"https://doi.org/10.1002/wjs.12402","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend adrenal venous sampling (AVS) for subtyping primary aldosteronism (PA). However, bilateral adrenal cannulation failure is common especially at low-volume centers. The role of unilateral-cannulating AVS in selecting patients for unilateral adrenalectomy is unclear.</p><p><strong>Methods: </strong>Fifty consecutive patients underwent AVS between 2009 and 2023 and thirty-three (66%) underwent unilateral adrenalectomy. We defined unilateral PA (uPA) by the normalized plasma aldosterone and the aldosterone-renin ratio following unilateral adrenalectomy. We examined the effectiveness of unilateral-cannulating AVS in identifying uPA.</p><p><strong>Results: </strong>88%, 50%, and 48% of patients had the left, right, and bilateral adrenal veins successfully cannulated, respectively. Among patients with bilateral successful cannulation, a lateralization index (LI) > 4 provided a sensitivity of 100% and a positive predictive value (PPV) of 86.7% for uPA. Thresholds for the contralateral suppression index (CSI) and relative aldosterone secretion index (RASI) were derived from this subgroup and applied to the entire cohort. CSI <0.5 demonstrated a sensitivity of 76.5% and PPV of 92.9% for uPA, whereas RASI >2.4 showed a sensitivity of 85.0% and PPV of 94.4% for uPA. With CSI <0.5 or RASI >2.4 combined, a higher PPV (95.5%) was achieved when compared to computed tomography and iodocholesterol scintigraphy (86.2% and 62.5%, respectively).</p><p><strong>Conclusion: </strong>Despite unsuccessful bilateral cannulation, our study confirms that unilateral-cannulating AVS can effectively select patients for unilateral adrenalectomy based on a combination of CSI or RASI criteria.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent elevation of parathyroid hormone after curative parathyroidectomy: A risk factor for recurrent hyperparathyroidism.","authors":"Sophie Dream, Gi Yoon Kim, Kara Doffek, Tina Wf Yen, Ty Carroll, Joseph Shaker, Douglas B Evans, Tracy S Wang","doi":"10.1002/wjs.12413","DOIUrl":"https://doi.org/10.1002/wjs.12413","url":null,"abstract":"<p><strong>Background: </strong>Up to 45% of patients may have persistently elevated parathyroid hormone (PTH) levels after curative parathyroidectomy for primary hyperparathyroidism (PHPT), although the clinical significance is unclear. We aimed to assess the long-term clinical significance of persistently elevated PTH early after parathyroidectomy.</p><p><strong>Methods: </strong>A prospectively collected institutional database was queried for patients who underwent parathyroidectomy for sporadic PHPT between 12/99 and 6/22 and had normal serum calcium levels at 6 months postoperatively. Demographic and clinical data were collected, including diagnoses associated with secondary HPT (gastrointestinal malabsorptive diseases, kidney disease, and vitamin D deficiency). Patients were divided into two groups: normal PTH or elevated PTH at 6 months postoperatively. The rate of persistently elevated PTH, average time to PTH normalization, and time to recurrence were determined.</p><p><strong>Results: </strong>The final cohort included 1146 patients; 849 (91%) had normal PTH levels and 194 (17%) had early postoperative normocalcemia with elevated PTH at 6 months postoperatively. Among 194 patients (mean follow-up: 50 ± 53 months), 14 (7.2%) developed recurrent pHPT and 86 (44.3%) had normalization of PTH levels (median time to normalization: 12 months) (IQR: 9 and 15). There was no difference in the presence of diagnoses associated with secondary HPT between patients who had recurrent PHPT, normalization of PTH levels, or remained normocalcemic with persistently elevated PTH levels. The median time to recurrence was 22 months (IQR: 11 and 48) for the 7.2% of patients who developed recurrent PHPT compared to 2.4% in the 849 patients with normal calcium and PTH levels at 6 months (p < 0.001).</p><p><strong>Conclusions: </strong>Following curative parathyroidectomy, persistent elevation of PTH levels is not uncommon. Although most patients have a durable cure, it may be an early sign of persistent/recurrent PHPT. Long-term surveillance for recurrence is necessary.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-year follow-up of a randomized clinical trial of unilateral thyroid lobectomy with or without postoperative levothyroxine treatment.","authors":"Marcin Barczyński, Filip Gołkowski, Alicja Hubalewska-Dydejczyk, Aleksander Konturek","doi":"10.1002/wjs.12403","DOIUrl":"https://doi.org/10.1002/wjs.12403","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to validate in 20-year follow-up (FU) the outcomes reported in World J Surg 2010; 34(6):1232-8 on recurrent nodular goiter in the contralateral thyroid lobe among patients after thyroid lobectomy (TL) for multinodular goiter (MNG) receiving versus not receiving postoperative prophylactic levothyroxine (LT4) treatment.</p><p><strong>Methods: </strong>Some 150 consenting patients underwent TL for MNG in 2000-2003. They were randomized to two groups, 75 patients each: (a) receiving prophylactic LT4 treatment postoperatively (dose range 75-125 microg/day to maintain thyroid-stimulating hormone values within 0.27-1.0 mU/L), and (b) not receiving LT4. Sixty-month FU was extended to 240 months for all the consenting patients. The primary outcome was prevalence of recurrent goiter. The secondary outcome was re-intervention rate for recurrent goiter. The outcomes were stratified according to individual iodine metabolism status assessed by urinary iodine excretion.</p><p><strong>Results: </strong>During the 5-year FU (5 patients were lost) recurrent goiter was found in patients receiving versus not receiving LT4 in 1.4% versus 16.7% (p = 0.001) whereas during 20-year FU (29 patients were lost) it was 3.3% versus 30.0% of patients, respectively (p = 0.031). During 20-year FU 4.9% versus 30.0%, respectively, of patients receiving versus not receiving LT4 required contralateral thyroid lobe treatment/surgery (p = 0.028). LT4 decreased recurrence rate among iodine-deficient patients (10.0% vs. 70.0%, respectively; p = 0.037) but not among iodine-sufficient patients (0.0% vs. 10.0%, respectively; p = 0.056).</p><p><strong>Conclusions: </strong>Twenty-year FU data confirmed that prophylactic LT4 treatment significantly decreased the recurrence of nodular goiter and the need for completion intervention/surgery, mostly among patients with iodine deficiency.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}