BACKGROUND: Successful preoperative localization plays an important role in patient selection for focused parathyroidectomy. METHODS: The case records of 499 consecutive patients with presumed hyperparathyroidism who underwent neck exploration were reviewed. Positive imaging patients (n = 373) had a localizing study that clearly showed a single abnormal parathyroid gland whereas negative imaging patients (n = 44) failed to localize or had discordant imaging results. RESULTS: Positive imaging patients were more likely to have a single adenoma (93.0% vs 72.1%; P < .001), and were less likely to require a bilateral exploration (8.1% vs 70.4%; P < .001). Negative imaging patients required more frozen sections (.9 +/- 1.3 vs .2 +/- .7; P < .001), and longer surgical time (77.3 +/- 52.5 min vs 48.4 +/- 34.6 min; P < .001). The cure rate was significantly higher in the positive imaging group (96.0% vs 87.1%; P < .03), with no difference in the incidence of complications (3.2% vs 2.3%; P value was not significant). CONCLUSIONS: Patients with unsuccessful or discordant preoperative localization have a higher incidence of multigland disease, lower cure rate, and consume more institutional resources than patients with successful preoperative localization.
BACKGROUND: Successful preoperative localization plays an important role in patient selection for focused parathyroidectomy. METHODS: The case records of 499 consecutive patients with presumed hyperparathyroidism who underwent neck exploration were reviewed. Positive imaging patients (n = 373) had a localizing study that clearly showed a single abnormal parathyroid gland whereas negative imaging patients (n = 44) failed to localize or had discordant imaging results. RESULTS: Positive imaging patients were more likely to have a single adenoma (93.0% vs 72.1%; P < .001), and were less likely to require a bilateral exploration (8.1% vs 70.4%; P < .001). Negative imaging patients required more frozen sections (.9 +/- 1.3 vs .2 +/- .7; P < .001), and longer surgical time (77.3 +/- 52.5 min vs 48.4 +/- 34.6 min; P < .001). The cure rate was significantly higher in the positive imaging group (96.0% vs 87.1%; P < .03), with no difference in the incidence of complications (3.2% vs 2.3%; P value was not significant). CONCLUSIONS:Patients with unsuccessful or discordant preoperative localization have a higher incidence of multigland disease, lower cure rate, and consume more institutional resources than patients with successful preoperative localization.
Authors: Vladimir K Neychev; Guennadi Kouniavsky; Zita Shiue; Don N Udall; Helina Somervell; Christopher B Umbricht; Martha A Zeiger Journal: World J Surg Date: 2011-01 Impact factor: 3.352
Authors: Franziska J Dekorsy; Leonie Beyer; Christine Spitzweg; Ralf Schmidmaier; Andrei Todica; Arnold Trupka; Clemens C Cyran; Frank Berger; Roland Ladurner; Petra Zimmermann; Thomas Knösel; Peter Bartenstein; Christian Lottspeich; Vera Wenter Journal: J Clin Med Date: 2022-05-23 Impact factor: 4.964
Authors: Pietro Giorgio Calò; Giuseppe Pisano; Giulia Loi; Fabio Medas; Alberto Tatti; Stefano Piras; Angelo Nicolosi Journal: Clin Med Insights Endocrinol Diabetes Date: 2013-10-23