{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:30:46Z","timestamp":1790739046355,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2008,1,15]],"date-time":"2008-01-15T00:00:00Z","timestamp":1200355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Substernal thyroidectomy (ST), as compared to conventional, cervical thyroidectomy, is a technically demanding procedure that is associated with increased morbidity and mortality. We tested the hypothesis that outcomes following ST are improved at centers that perform a high volume of thyroidectomies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent ST from 1998 to 2004 were extracted from the New York State Statewide Planning and Research Cooperative System database. Hospital volume of thyroidectomies was divided into low (&lt;33 per year), middle (33\u201399 per year), and high (\u2265100 per year) volumes. Outcome variables included hospital length of stay (LOS), recurrent laryngeal nerve (RLN) injury, hypoparathyroidism, postoperative bleeding, respiratory failure, blood transfusion, and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1153 STs were analyzed; 372 (32.2%) were performed at low\u2010volume centers, 388 (33.7%) at middle\u2010volume centers, and 393 (34.0%) at high\u2010volume centers. Linear associations were observed between increasing hospital volume of thyroidectomies and decreasing age (<jats:italic>p<\/jats:italic> = 0.003), increasing co\u2010morbidity (<jats:italic>p<\/jats:italic> &lt; 0.0001), increased likelihood of total versus subtotal thyroidectomy (<jats:italic>p<\/jats:italic> &lt; 0.0001), and increased likelihood of thyroid malignancy (<jats:italic>p<\/jats:italic> &lt; 0.0001). Despite this, increasing hospital volume of thyroidectomies predicted a decreased likelihood of overall complications (<jats:italic>p<\/jats:italic> = 0.005), postoperative bleeding (<jats:italic>p<\/jats:italic> = 0.01), blood transfusion (<jats:italic>p<\/jats:italic> = 0.04), respiratory failure (<jats:italic>p<\/jats:italic> = 0.04) and mortality (<jats:italic>p<\/jats:italic> = 0.004), as well as a trend toward a decreased LOS (<jats:italic>p<\/jats:italic> = 0.06). The overall complication rate and the mortality rate remained significantly associated with volume group by multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite more extensive surgery on patients with greater co\u2010morbidity, LOS, morbidity, and mortality were all decreased when ST occurred at hospitals that perform a high volume of thyroidectomies.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-007-9347-1","type":"journal-article","created":{"date-parts":[[2008,1,14]],"date-time":"2008-01-14T20:46:43Z","timestamp":1200343603000},"page":"740-746","source":"Crossref","is-referenced-by-count":51,"title":["Effect of Hospital Volume of Thyroidectomies on Outcomes Following Substernal Thyroidectomy"],"prefix":"10.1002","volume":"32","author":[{"given":"Fredric M.","family":"Pieracci","sequence":"first","affiliation":[{"name":"Department of Surgery, Department of Public Health Weill Medical College of Cornell University 411 East 69th Street, KB\u2010220 10021 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Thomas J.","family":"Fahey","sequence":"additional","affiliation":[{"name":"Department of Surgery, Department of Public Health Weill Medical College of Cornell University 411 East 69th Street, KB\u2010220 10021 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,1,15]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.20.1747"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(99)70234-5"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000140752.74893.24"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1091\u2010255X(98)80011\u20105"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(01)00614\u20106"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(20010415)91:8<1574::AID\u2010CNCR1168>3.0.CO;2\u20102"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.02.002"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.1.13"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.11.2292"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198107233050405"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa012337"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.138.7.721"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010006\u20109005\u20100"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199511000\u201000006"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.9.1164"},{"key":"e_1_2_6_17_2","unstructured":"http:\/\/www.leapfroggroup.org. Accessed October 3 2007"},{"key":"e_1_2_6_18_2","unstructured":"http:\/\/www.facs.org\/cqi\/bscn\/levelsdefined.html. Cited October 3 (2007)"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200204113461512"},{"key":"e_1_2_6_20_2","first-page":"165","article-title":"Management of substernal goitre","volume":"21","author":"Wax MK","year":"1992","journal-title":"J Otolaryngol"},{"key":"e_1_2_6_21_2","first-page":"220","article-title":"Operative management of substernal goiter: analysis of 52 patients","volume":"86","author":"Arici C","year":"2001","journal-title":"Int Surg"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595\u2010004\u20102823\u20104"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480206800306"},{"key":"e_1_2_6_24_2","first-page":"889","article-title":"Retrosternal goiter: a six\u2010year institutional review","volume":"64","author":"Moron JC","year":"1998","journal-title":"Am Surg"},{"key":"e_1_2_6_25_2","first-page":"194","article-title":"Surgical treatment of substernal goiter","volume":"85","author":"Ozdemir A","year":"2000","journal-title":"Int Surg"},{"key":"e_1_2_6_26_2","first-page":"205","article-title":"Retrosternal goiters: safety of surgical treatment","volume":"88","author":"Parra\u2010Membrives P","year":"2003","journal-title":"Int Surg"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348949910800515"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.139.6.656"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.1.82"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)46628-4"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199809000\u201000005"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.03.010"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(92)90133\u20108"},{"key":"e_1_2_6_34_2","volume-title":"Applied Regression Analysis and Other Multivariable Methods","author":"Kleinbaum DG","year":"1988"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000089855.96280.4a"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0748\u20107983(96)80004\u20107"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0883\u20105403(05)80119\u20106"},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199802000\u201000001"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.12.008"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199909000\u201000013"},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-8-200310210-00009"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-007-9347-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-007-9347-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-007-9347-1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-007-9347-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T15:02:41Z","timestamp":1704898961000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-007-9347-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,1,15]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2008,5]]}},"alternative-id":["10.1007\/s00268-007-9347-1"],"URL":"https:\/\/doi.org\/10.1007\/s00268-007-9347-1","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,1,15]]}}}