scholarly journals A 20-Year Study on 190 Patients With Primary Hyperparathyroidism in a Developing Country: Turkey Experience

2015 ◽  
Vol 100 (4) ◽  
pp. 648-655 ◽  
Author(s):  
Arif Usta ◽  
Etem Alhan ◽  
Akif Cinel ◽  
Serdar Türkyılmaz ◽  
Cihangir Erem
Keyword(s):  
Primary Hyperparathyroidism ◽  
Imaging Techniques ◽  
Operation Time ◽  
Neck Exploration ◽  
The Common ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Surgical Treatments ◽  
Unilateral Neck Exploration ◽  
Pth Level

The aim of this study was to present our 20-year experience regarding primary hyperparathyroidism (PHPT). PHPT patients who underwent parathyroidectomy in our clinic were reviewed retrospectively. There were 190 PHPT patients, of whom 137 were asymptomatic (72%). The mean serum calcium at the time of diagnosis was 11.9 ± 2.2 mg/dL. The mean parathyroid hormone (PTH) level was 467 ± 78 pg/mL. Ultrasonography (USG) identified all abnormal glands accurately (82.6%) and Technetium-99m sestamibi scintigraphy (MIBI) was used in 89.4% of the patients and magnetic resonance imaging (MRI) in 61%. The common use of USG and MIBI detected 92% of the lesions. Bilateral neck exploration (BNE) was performed in 12.2% of the patients and focused unilateral neck exploration (FUNE) in the remaining 87.8%. Surgical intervention was unsuccessful in 1 patient (0.5%). The conversion ratio from FUNE to BNE was 5.2%. The mean operation time and mean hospital stay decreased significantly in patients with FUNE. Pathologic examination revealed single adenoma in 93% of the patients. New imaging techniques result in the conversion of surgical treatments of PHPT. FUNE in parathyroidectomy performed by an experienced surgeon may provide successful treatment rates.

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

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.

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.

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