scholarly journals Surgical Approach to Primary Hyperparathyroidism in Patients with Concomitant Thyroid Diseases: A Retrospective Single Center Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Elena Castellano ◽  
Paolo Benso ◽  
Roberto Attanasio ◽  
Alberto Boriano ◽  
Corrado Lauro ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Surgical Approach ◽  
Thyroid Disease ◽  
Thyroid Diseases ◽  
Neck Exploration ◽  
Cure Rate ◽  
Surgical Time ◽  
Single Center Study ◽  
Unilateral Neck Exploration ◽  
Benign Thyroid

Background. Primary hyperparathyroidism (PHPT) and thyroid diseases are a frequent concomitant occurrence, but the surgical approach to associated disease is still debated. Methods. We retrospectively evaluated a series of PHPT patients focusing on thyroid disease and surgery. Results. Among 238 PHPT patients undergoing parathyroidectomy (PTX) between 2002 and 2017, 128 were affected also by a benign thyroid disease, namely, goiter in 118 (76 multinodular (MNG) and 42 uninodular (UNG)), autoimmune thyroiditis in 10, and hyperthyroidism in 21. Surgical approach was unilateral neck exploration (UNE) in 59 patients and bilateral neck exploration (BNE) in 69. The PHPT cure rate was 94%. On comparing patients submitted to PTX only and PTX plus thyroidectomy (TX), in the latter MNG and hyperthyroidism were more frequent, and surgical time and length of stay were longer. No difference in surgical complications was found between patients undergoing UNE and BNE. Conclusion. PHPT patients with a concomitant thyroid disease underwent double surgery in almost two-thirds of the cases, mostly by BNE. The main factors driving the decision to perform concomitant PTX and TX were the presence of thyroid nodular disease with the nodule site ipsilateral to the presurgically localized parathyroid adenoma.

scholarly journals Surgeon-performed Ultrasound in Preoperative Parathyroid Localization: The Cutting Edge of Endocrine Surgeon

2009 ◽  
Vol 1 (1) ◽  
pp. 19-22
Author(s):  
MA Yahya ◽  
K Normayah ◽  
AN Hisham
Keyword(s):  
Primary Hyperparathyroidism ◽  
Bilateral Neck Exploration ◽  
Preoperative Localization ◽  
Neck Exploration ◽  
Preoperative Imaging ◽  
Cure Rate ◽  
Unilateral Approach ◽  
Unilateral Exploration ◽  
Parathyroid Localization ◽  
Unilateral Neck Exploration

ABSTRACT Background Over the years surgery for primary hyperparathyroidism has evolved from bilateral neck exploration to focus unilateral approach. This has been made possible by the advancement in localization technique and availability of the preoperative imaging. This study aimed to determine the feasibility and accuracy of focus unilateral neck approach for primary hyperparathyroidism with surgeon- performed ultrasound as the main decisive preoperative localization imaging technique. Method The decision of focus unilateral approach was stipulated if an enlarged parathyroid adenoma was confidently seen in the preoperative localization by surgeon-performed ultrasound. The focus unilateral exploration was terminated if the diseased gland was found. Nonetheless if in doubt, the exploration was extended to include the opposite side of the neck. More importantly any negative preoperative ultrasound will be considered for bilateral neck exploration. Results 118 consecutive patients were accrued in this study, 76 females and 42 males with mean age of 50 years. Focus unilateral neck exploration was performed on 86 (72.9%) patients and 96.5% of them were successfully explored and cured. 13 (13.1%) patients had exploration of both sides of the neck although the initial decision was only to explore one side. The overall cure rate was 93.2% with the sensitivity and specificity of ultrasound were 78.3% and 95.1% respectively. Conclusion Surgeon-performed ultrasound in parathyroid localization in coupled with focus unilateral approach in primary HPT can be performed 73% of patients with a success rate of more than 96%.

Unilateral neck exploration under local anesthesia: The approach of choice for asymptomatic primary hyperparathyroidism

Surgery ◽  
1999 ◽  
Vol 126 (6) ◽  
pp. 1004-1010 ◽  
Author(s):  
William B. Inabnet ◽  
Yvonne Fulla ◽  
Bruno Richard ◽  
Philippe Bonnichon ◽  
Philippe Icard ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Local Anesthesia ◽  
Neck Exploration ◽  
Asymptomatic Primary Hyperparathyroidism ◽  
Unilateral Neck Exploration

99MTc-Sestamibi as sole technique in selection of primary hyperparathyroidism patients for unilateral neck exploration

Surgery ◽  
2008 ◽  
Vol 144 (3) ◽  
pp. 454-459 ◽  
Author(s):  
Dolores Moure ◽  
Eduardo Larrañaga ◽  
Luis Domínguez-Gadea ◽  
Manuel Luque-Ramírez ◽  
Lia Nattero ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Neck Exploration ◽  
Unilateral Neck Exploration ◽  
99Mtc Sestamibi ◽  
Selection Of

The neutrophil-to-lymphocyte ratio as a diagnostic marker for malignant thyroid diseases

2017 ◽  
Vol 42 (5) ◽  
Author(s):  
Sezgin Zeren ◽  
İsa Özbay ◽  
Zülfü Bayhan ◽  
Fatma Emel Koçak ◽  
Bercis Imge Ucar ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Diagnostic Marker ◽  
Complete Blood Count ◽  
Thyroid Diseases ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Malignant Group ◽  
The Mean ◽  
Benign Group ◽  
Benign Thyroid

AbstractBackground:The neutrophil-lymphocyte ratio (NLR) is a good marker of malignant diseases. The aim of this study was to investigate NLR as a diagnostic marker of thyroid cancer in patients with malignant thyroid diseases compared to those with benign thyroid diseases.Methods:Two hundred and fifty three patients were divided into two groups: benign and malignant thyroid disease patients. Malignant thyroid disease group was not sub-grouped further into differentiated and undifferentiated. The preoperative complete blood count and biochemical parameters, including NLR, were evaluated.Results:The mean neutrophil count was found to be significantly higher, whereas the mean lymphocyte count was found to be significantly lower in the malignant group which includes 40 of the patients. As a result, NLR was significantly higher in the malignant group than in the benign group (p<0.001).Conclusion:This is the first study to show the value of NLR as a marker for malignant thyroid diseases including all subtypes.

Success of Preoperative Imaging and Unilateral Neck Exploration for Primary Hyperparathyroidism

1999 ◽  
Vol 121 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Angie U. Song ◽  
Thomas E. Phillips ◽  
Charles V. Edmond ◽  
David W. Moore ◽  
Stephen K. Clark
Keyword(s):  
Primary Hyperparathyroidism ◽  
Neck Exploration ◽  
Preoperative Imaging ◽  
Unilateral Neck Exploration

Can parathyroidectomy for primary hyperparathyroidism be carried out as a day-case procedure?

2006 ◽  
Vol 120 (11) ◽  
pp. 939-941 ◽  
Author(s):  
E R M Carr ◽  
K Contractor ◽  
D Remedios ◽  
M Burke
Keyword(s):  
Primary Hyperparathyroidism ◽  
Feasibility Study ◽  
Bilateral Neck Exploration ◽  
Neck Exploration ◽  
Day Case ◽  
Surgical Exploration ◽  
Bilateral Exploration ◽  
Imaging Results ◽  
Unilateral Neck Exploration

Introduction: Surgery for primary hyperparathyroidism has traditionally involved a bilateral neck exploration performed as an in-patient procedure. We present a feasibility study to demonstrate whether, with a focused surgical exploration, the procedure can be carried out as a day case.Method: Eighty-seven patients had pre-operative sestamibi and ultrasound scans of the neck. When the results of these scans agreed, a unilateral neck exploration was carried out.Results: Sixty-seven patients received a focused approach parathyroidectomy. Ninety-seven per cent of these patients were normocalcaemic after the first operation. All patients who fitted the day-case criteria left hospital the following morning.Discussion: When pre-operative imaging results agree, a parathyroidectomy can be carried out using a unilateral neck exploration, avoiding the increased risks associated with a bilateral exploration.Conclusion: Parathyroidectomy can be safely carried out as a day-case procedure in selected patients.

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