Parathyroidectomy via bilateral cervical exploration: A retrospective review of 866 cases

Low, Rick A.; Katz, Alfred D.

doi:10.1002/(sici)1097-0347(199810)20:7<583::aid-hed1>3.0.co;2-x

Cited by 91 publications

(45 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, in a retrospective review of 866 consecutive BNE performed by a single surgeon between 1960 and 1997, the pathology consisted of single adenomas in only 77% of patients and hyperplasia in 21% [22]. More recently, in a study of 350 patients undergoing BNE regardless of the findings on preoperative imaging, additional abnormal parathyroid glands were found on complete exploration in 15% of patients with concordant sestamibi/ ultrasound scan/ioPTH suggestive of a single-gland disease [23].…”

Section: Intraoperative Findings With Une Vs Bnementioning

confidence: 99%

Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations

Mihai

Barczyński

Iacobone

et al. 2009

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

Section: Intraoperative Findings With Une Vs Bnementioning

confidence: 99%

Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations

Mihai

Barczyński

Iacobone

et al. 2009

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…However, the use of sestamibi imaging cannot be uniformly recommended in patients without prior neck surgery. In the hands of an experienced surgeon, successful parathyroid surgery can be expected 95% of the time in patients who have not had previous neck surgery (5,37). In these patients, there is no evidence that operative time is reduced or that the complication frequency decreased, or even that the success rate of parathyroid surgery is greater with preoperative imaging (38,39).…”

Section: Management Of Primary Hyperparathyroidism -Treating Older Pamentioning

confidence: 99%

Primary hyperparathyroidism: diagnosis and management in the older individual

Boonen

Vanderschueren²,

Pelemans³

et al. 2004

European Journal of Endocrinology

View full text Add to dashboard Cite

As more and more cases of primary hyperparathyroidism are being detected by screening for serum calcium concentration, the majority of patients are older individuals who are asymptomatic or have symptoms which are difficult to ascribe to hyperparathyroidism. Long-term follow-up has provided evidence that most asymptomatic patients who do not undergo parathyroidectomy will not develop symptomatic complications. Some asymptomatic patients, however, have progression of disease over time. These observations and the lack of reliable predictors of the rate of progression in most patients reinforce the need for careful monitoring in elderly individuals who do not undergo surgery. Biannual measurements of serum calcium concentrations and annual measurements of urinary calcium excretion and bone mineral density should be performed in all patients who are managed conservatively. In elderly patients with symptomatic or complicated primary hyperparathyroidism, parathyroidectomy results in biochemical cure and increased bone density, both at the lumbar spine and the femoral neck, and should be considered. Criteria for surgery include significant hypercalcemia (.1 mg/dl above the upper limit of normal), marked hypercalciuria (. 400 mg per day), low bone density, unexplained renal insufficiency and an episode of acute primary hyperparathyroidism. Consideration of parathyroidectomy should also be given to elderly patients with primary hyperparathyroidism who are vitamin D deficient. Radionuclide scanning has become the initial non-invasive study of choice when parathyroid gland localization is necessary before parathyroidectomy; this is generally for fragile patients and reoperative cases. In a subset of older individuals, surgery may not be an option because of coexisting medical problems even though surgical indications are present.European Journal of Endocrinology 151 297-304

show abstract

“…More recently, several authors proposed more expansive criteria for surgical therapy, excluding only those patients who are not able to tolerate surgery [6,7]. Nevertheless, with the variable number and anatomic location of parathyroid glands, preoperative imaging has rarely been used for traditional open-neck surgery [8][9][10][11]. Since 90 % of patients with PHPT have a single gland adenoma, minimally invasive parathyroidectomy (MIP) was introduced [12][13][14], with decreased intraoperative time, size of surgical incision and complication rates [15,16].…”

Section: Introductionmentioning

confidence: 99%

MR appearance of parathyroid adenomas at 3 T in patients with primary hyperparathyroidism: what radiologists need to know for pre-operative localization

et al. 2015

View full text Add to dashboard Cite

show abstract

Parathyroidectomy via bilateral cervical exploration: A retrospective review of 866 cases

Cited by 91 publications

References 13 publications

Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations

Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations

Primary hyperparathyroidism: diagnosis and management in the older individual

MR appearance of parathyroid adenomas at 3 T in patients with primary hyperparathyroidism: what radiologists need to know for pre-operative localization

Contact Info

Product

Resources

About