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Articles by E. G Grubbs
Total Records ( 3 ) for E. G Grubbs
  C. S Landry , E. G Grubbs and N. D. Perrier

Hypothesis  Robotic-assisted transaxillary surgery (RATS) for the removal of thyroid glands is feasible by surgeons in the United States.

Design  Case report.

Setting  Academic research.

Patient  A 53-year-old woman.

Intervention  Total thyroidectomy via the transaxillary approach.

Main Outcome Measure  Successful completion thyroidectomy using bilateral RATS.

Results  Right thyroid lobectomy was performed via RATS to remove a 2.2-cm Hurthle cell neoplasm of the thyroid gland per cytologic analysis. Final pathologic analysis was consistent with minimally invasive follicular thyroid carcinoma. The patient then underwent completion thyroidectomy via left-sided RATS. There were no complications.

Conclusions  Bilateral RATS to perform total thyroidectomy is a feasible option in properly selected patients. To our knowledge, this is the first reported use of this technique in the United States.

  E. J Silberfein , R Bao , A Lopez , E. G Grubbs , J. E Lee , D. B Evans and N. D. Perrier

Objectives  To evaluate and categorize the locations of missed parathyroid glands found during reoperative parathyroidectomy and to determine any factors associated with these locations.

Design  Retrospective cohort study.

Setting  Tertiary referral center.

Patients  Fifty-four patients who underwent reoperative parathyroidectomy for persistent or recurrent hyperparathyroidism from January 1, 2005, through January 1, 2009.

Main Outcome Measures  Location of missed parathyroid glands and their association with continuous variables were analyzed using a Kruskal-Wallis test, and associations between gland location and categorical variables were evaluated using the Fisher exact test.

Results  Among 54 patients, 50 abnormal parathyroid glands were identified, resected, and classified as follows: 5 (10%) were type A (adherent to the posterior thyroid capsule); 11 (22%), type B (behind the thyroid in the tracheoesophageal groove); 7 (14%), type C (close to the clavicle in the prevertebral space); 3 (6%), type D (directly over the recurrent laryngeal nerve); 9 (18%), type E (easy to identify; near the inferior thyroid pole); 13 (26%), type F (fallen into the thymus); and 2 (4%), type G (gauche, within the thyroid gland). No demographic, biochemical, or pathological factors were significantly associated with gland location. Among the 43 patients followed up for 6 months, 40 (93%) had documented cures.

Conclusions  Missed glands after parathyroidectomy for hyperparathyroidism can be found in standard locations in most cases. A standardized nomenclature system based on the regional anatomy and the embryology of the parathyroid glands can guide a systematic exploration for parathyroid adenomas that are not easily identified and facilitate communication about gland locations.

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