The Surgical Management of Asymptomatic Primary Hyperparathyroidism: Proceedings of the Fourth International Workshop

Udelsman, Robert; Åkerström, Göran; Biagini, Carlo; Duh, Quan‐Yang; Miccoli, Paolo; Niederle, Bruno; Tonelli, Francesco

doi:10.1210/jc.2014-2000

Cited by 258 publications

(283 citation statements)

References 71 publications

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“…As summarized recently, all patients with PHPT who meet surgical criteria should be referred to an experienced endocrine surgeon to discuss the risks, benefits and potential complications of surgery (18). A randomized controlled clinical trial of surgery vs no surgery in patients with 'mild' asymptomatic PHPT demonstrated the benefit of surgery on bone mineral density, quality of life and psychological functions (12).…”

Section: ) No Alteration In Renal Function (Creatinine Clearancementioning

confidence: 99%

Is surgery necessary for ‘mild’ or ‘asymptomatic’ hyperparathyroidism?

Niederle¹,

Wémeau

2015

European Journal of Endocrinology

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A large majority of the currently diagnosed patients with hyperparathyroidism (PHPT) are mild or asymptomatic, mainly women after menopause. Following the debate held at the 16th European Congress of Endocrinology in Wroclaw (Poland) from May 3-7, 2014, arguments are here presented by a surgeon and a medical practitioner considering these situations rather have to profit from surgery, or simply from survey. For the trained endocrine surgeon, it is evident that parathyroidectomy confirms the diagnosis and undoubtedly reduces the discomfort felt by certain patients, prevents all risks of complications, removes patients and medical teams from the monitoring and represents a real individual financial benefit. On the other hand, the medical practitioner considers that mild or asymptomatic PHPT is commonly stable, and very rare are the subjects at risk of complications, particularly of fractures; prevention of vascular and metabolic disorders, nephrolithiasis and bone rarefaction justify regular physical exercise, a safe alimentation, a sufficient calcium and high water intake, the correction of the frequent deficit in vitamin D; finally has also to be considered the impossibility to refer to specialized (endocrine) surgeons, the enormous cohort of subjects more than 50 years with 'mild' or 'asymptomatic' PHPT. The surgeon and the medical practitioner agree to consider that in patients with 'mild' or 'asymptomatic' disease, there is no place for medical treatments, in particular calcimimetics and bisphophonates. Both agree that further studies are needed to clarify the long-term prognosis of operated and non-operated PHPT in term of fractures, cardiovascular risk and mortality. Individual and collective cost/benefit ratios of surgery or survey are also still imperfectly evaluated.

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Section: ) No Alteration In Renal Function (Creatinine Clearancementioning

confidence: 99%

Is surgery necessary for ‘mild’ or ‘asymptomatic’ hyperparathyroidism?

Niederle¹,

Wémeau

2015

European Journal of Endocrinology

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“…Accepted guidelines for surgical intervention in patients with PHPT include all symptomatic patients (renal, bone manifestations) and asymptomatic patients less than 50 years of age or with biochemical indices including elevated serum calcium, reduced creatinine clearance, and signs of osteoporosis, as well as the relative indication for patients with neuropsychiatric manifestations of PHPT (1). Ectopic parathyroid adenoma is a well-described phenomenon and can be a cause of an unsuccessful parathyroidectomy.…”

Section: Introductionmentioning

confidence: 99%

Parathyroid Adenoma of the Piriform Sinus: Case Series, Embryologic Basis, and Review of the Literature

Helman

Moubayed

et al. 2017

AACE Clinical Case Reports

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Objective: Parathyroidectomy is a procedure best performed by experienced parathyroid surgeons. Ectopic parathyroid adenoma is a well-described entity that can lead to a failed parathyroidectomy. Parathyroid adenoma of the piriform sinus is especially rare.Methods: Herein, we present a case series of 2 patients with ectopic parathyroid adenoma of the piriform sinus who underwent transoral resection of the lesion.Results: Both patients were successfully treated in our case series, and enjoyed an appropriate return to normal calcium and parathyroid levels. We further highlight the embryologic basis for this entity and present the available literature regarding surgical extirpation of parathyroid adenoma of the piriform sinus.Conclusion: Herein, we describe a transoral approach to piriform sinus adenomas in 2 patients. Both procedures were successful and without sequelae. We further provide a brief discussion of the management of other known cases of piriform sinus adenoma as well as their embryologic underpinnings. (AACE Clinical Case Rep. 2017;3:e379-e383) Abbreviations: CT = computed tomography; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone; SPECT = single-photon emission computed tomography

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“…1 However, the imaging tests, the treatment, and the intraoperative control arrangements are still being debated. There are two different surgical strategies: Exploratory cervicotomy with visualisation of the four glands or focused minimally invasive surgical approach 2,3 enabling the visualization of one or two glands.…”

Section: Introductionmentioning

confidence: 99%

Frozen Tissue Examination: Is It really no Longer of Use in Parathyroid Surgery? Single-center Retrospective Study on 97 Patients treated by minimally Invasive Approach

Furderer¹,

Bouviez²,

Paquette³

et al. 2017

World Journal of Endocrine Surgery

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Introduction: Surgery, by minimally invasive approach, has become the gold standard in the treatment of primary hyperparathyroidism. However, the preoperative and intraoperative examinations to be performed are still subject to debate. The frozen tissue examination of the parathyroidectomy specimen is often criticized, as it is deemed difficult and noninformative in case of multiglandular disease. The primary objective was to study the result of the frozen tissue examination and its benefit in the operative strategy in minimally invasive surgery.

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The Surgical Management of Asymptomatic Primary Hyperparathyroidism: Proceedings of the Fourth International Workshop

Cited by 258 publications

References 71 publications

Is surgery necessary for ‘mild’ or ‘asymptomatic’ hyperparathyroidism?

Is surgery necessary for ‘mild’ or ‘asymptomatic’ hyperparathyroidism?

Parathyroid Adenoma of the Piriform Sinus: Case Series, Embryologic Basis, and Review of the Literature

Frozen Tissue Examination: Is It really no Longer of Use in Parathyroid Surgery? Single-center Retrospective Study on 97 Patients treated by minimally Invasive Approach

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