Long-Term Results after Surgical Treatment of Primary Hyperparathyroidism

Niederle, Bruno; Roka, R.; Fritsch, A.

doi:10.1159/000412366

Cited by 12 publications

(22 citation statements)

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“…As shown in this study, a number of patients clinically classified “asymptomatic” may have “silent” organ manifestations and therefore be in fact “symptomatic.” In many ways, “symptomatic” patients profit from surgery [ 2 , 9 ]. In the current guidelines [ 1 ], “asymptomatic” patients compose a patients’ group inheriting only a “relative indication” for surgery while in “symptomatic” patients early surgical intervention is recommended [ 23 ], so those patient groups need to be discriminated [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative radiological assessment is crucial to determine the directions of further postoperative follow-up in patients with “silent” kidney stones [ 2 , 10 , 13 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, patients with PHPT and kidney stone disease are symptomatic by definition. Those patients are at a 15 to 30 % higher risk to develop kidney stones than the general population, in which an incidence of 1 % is described [ 2 – 6 ]. A valid detection tool for kidney stones is crucial at the initial diagnosis of PHPT—especially in patients with mildly elevated laboratory findings [ 7 , 8 ]—and in the course of follow-up to detect patients with symptomatic disease.…”

Section: Introductionmentioning

confidence: 99%

“…The only cure then is parathyroidectomy with a restoration of normocalcemia which, in the majority of patients, results in a resolution of organic manifestation [ 9 ]. Nevertheless, postoperative persistent and recurrent stone disease has been reported in up to 17 % in long-term follow-up [ 2 , 9 – 11 ]. Calculi burden and new stone formation is important in the clinical evaluation of patients with kidney stone disease in PHPT [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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“Silent” kidney stones in “asymptomatic” primary hyperparathyroidism—a comparison of multidetector computed tomography and ultrasound

Selberherr

Hörmann

Prager

et al. 2016

Langenbecks Arch Surg

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PurposeThe purpose of this study was to demonstrate the high number of kidney stones in primary hyperparathyroidism (PHPT) and the low number of in fact “asymptomatic” patients.MethodsForty patients with PHPT (28 female, 12 male; median age 58 (range 33–80) years; interquartile range 17 years [51–68]) without known symptoms of kidney stones prospectively underwent multidetector computed tomography (MDCT) and ultrasound (US) examinations of the urinary tract prior to parathyroid surgery. Images were evaluated for the presence and absence of stones, as well as for the number of stones and sizes in the long axis. The MDCT and US examinations were interpreted by two experienced radiologists who were blinded to all clinical and biochemical data. Statistical analysis was performed using the Wilcoxon signed-rank test.ResultsUS revealed a total of 4 kidney stones in 4 (10 %) of 40 patients (median size 6.5 mm, interquartile range 11.5 mm). MDCT showed a total of 41 stones (median size was 3 mm, interquartile range 2.25 mm) in 15 (38 %) of 40 patients. The number of kidney stones detected with MDCT was significantly higher compared to US (p = 0.00124).ConclusionsMDCT is a highly sensitive method for the detection of “silent” kidney stones in patients with PHPT. By widely applying this method, the number of asymptomatic courses of PHPT may be substantially reduced. MDCT should be used primarily to detect kidney stones in PHPT and to exclude asymptomatic PHPT.

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Section: Discussionmentioning

confidence: 99%

“…Preoperative radiological assessment is crucial to determine the directions of further postoperative follow-up in patients with “silent” kidney stones [ 2 , 10 , 13 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“Silent” kidney stones in “asymptomatic” primary hyperparathyroidism—a comparison of multidetector computed tomography and ultrasound

Selberherr

Hörmann

Prager

et al. 2016

Langenbecks Arch Surg

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“…Wide variation exists among reported outcomes following transthoracic surgery for thyroid cancer, with significant change over time. 1,2,[6][7][8][9][10][11][12] The most common complication is transient (up to 50%) or permanent (up to 40%) hypoparathyroidism; less commonly, transient (up to 5%) and permanent (1%) recurrent laryngeal nerve palsy may occur, especially in the re-operative setting. Complications specific to the transthoracic approach include sternal wound infection, bleeding, chest wall dysfunction and pain.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of combined cervical and transthoracic surgical approaches in patients with advanced thyroid cancer

et al. 2022

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Background Advanced thyroid disease involving the mediastinum may be managed surgically with a combined transcervical and transthoracic approach. Contemporary analysis of this infrequently encountered cohort will aid the multidisciplinary team in personalizing treatment approaches. Methods Retrospective review of patients undergoing combined transcervical and transthoracic surgery for thyroid cancer at a single high‐volume institution from 1994 to 2015. Results Thirty‐eight patients with median age 59 years (range 28–76) underwent surgery without perioperative mortality. Most patients had primary disease. A majority had distant metastases outside the mediastinum but had locoregionally curable disease. Common complications were temporary (39%) and permanent (18%) hypoparathyroidism, and wound infection (13%). One‐year overall survival was 84%; 1‐year locoregional disease‐free survival was 64%. Median time to locoregional recurrence was 36 months. Only esophageal invasion was associated with worse oncologic outcomes. Conclusions Combined transcervical and transthoracic surgery for advanced thyroid cancer can be performed without mortality and with acceptable morbidity.

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