Hadiza S Kazaure1, Samantha Thomas2, Randall P Scheri3, Michael T Stang3, Sanziana A Roman3, Julie A Sosa3. 1. Department of Surgery, Duke University Medical Center, Durham, NC. Electronic address: hadiza.kazaure@duke.edu. 2. Duke University, Department of Biostatistics and Bioinformatics, Durham, NC. 3. Department of Surgery, Duke University Medical Center, Durham, NC.
Abstract
BACKGROUND: Multi-institutional data describing remedial parathyroidectomy compared with index parathyroidectomy are scarce. METHODS: Using data in the Collaborative Endocrine Surgery Quality Improvement Program (2014-2017), baseline characteristics and outcomes of patients undergoing remedial parathyroidectomy versus index parathyroidectomy were examined using bivariate and multivariate methods. Rates of hypercalcemia and hypocalcemia at ≥ 180 days were assessed. RESULTS: Among 6,795 patients, 367 (5.4%) underwent remedial parathyroidectomy. A single localization study was done in 24.8% versus 26.9% of remedial parathyroidectomy versus index parathyroidectomy (P = .37). Patients undergoing remedial parathyroidectomy had higher rates of preoperative laryngoscopy (45.5% versus 6.2%, P < .001), intraoperative nerve monitoring (57.5% versus 34.5%, P < .001), and < 50% drop in hyperparathyroidism than those undergoing index parathyroidectomy (9.6% versus 3.3%, P < .001). Among patients with ≥ 180 days follow-up, none of the remedial parathyroidectomy versus three index parathyroidectomy patients (0.3%) had vocal cord dysfunction. Hypercalcemia rates for remedial parathyroidectomy and index parathyroidectomy were 10.5% versus 5.0 (P = .07), and hypocalcemia rates were 10.5% versus 2.4% (P < .001). After multivariate adjustment, failure to cure was 4.0 times more likely in remedial parathyroidectomy than index parathyroidectomy (P < .001). CONCLUSION: This is the first multi-institutional examination of remedial parathyroidectomy outcomes in the Collaborative Endocrine Surgery Quality Improvement Program. Nerve injury rates are low; high rates of hypercalcemia and hypocalcemia suggest potential opportunities to refine the preoperative and intraoperative management of patients undergoing remedial parathyroidectomy.
BACKGROUND: Multi-institutional data describing remedial parathyroidectomy compared with index parathyroidectomy are scarce. METHODS: Using data in the Collaborative Endocrine Surgery Quality Improvement Program (2014-2017), baseline characteristics and outcomes of patients undergoing remedial parathyroidectomy versus index parathyroidectomy were examined using bivariate and multivariate methods. Rates of hypercalcemia and hypocalcemia at ≥ 180 days were assessed. RESULTS: Among 6,795 patients, 367 (5.4%) underwent remedial parathyroidectomy. A single localization study was done in 24.8% versus 26.9% of remedial parathyroidectomy versus index parathyroidectomy (P = .37). Patients undergoing remedial parathyroidectomy had higher rates of preoperative laryngoscopy (45.5% versus 6.2%, P < .001), intraoperative nerve monitoring (57.5% versus 34.5%, P < .001), and < 50% drop in hyperparathyroidism than those undergoing index parathyroidectomy (9.6% versus 3.3%, P < .001). Among patients with ≥ 180 days follow-up, none of the remedial parathyroidectomy versus three index parathyroidectomy patients (0.3%) had vocal cord dysfunction. Hypercalcemia rates for remedial parathyroidectomy and index parathyroidectomy were 10.5% versus 5.0 (P = .07), and hypocalcemia rates were 10.5% versus 2.4% (P < .001). After multivariate adjustment, failure to cure was 4.0 times more likely in remedial parathyroidectomy than index parathyroidectomy (P < .001). CONCLUSION: This is the first multi-institutional examination of remedial parathyroidectomy outcomes in the Collaborative Endocrine Surgery Quality Improvement Program. Nerve injury rates are low; high rates of hypercalcemia and hypocalcemia suggest potential opportunities to refine the preoperative and intraoperative management of patients undergoing remedial parathyroidectomy.
Authors: J L Becker; V Patel; K J Johnson; M Guerrero; R R Klein; G F Ranvier; R P Owen; P Pawha; K Nael Journal: AJNR Am J Neuroradiol Date: 2020-03-12 Impact factor: 3.825
Authors: T Weber; C Dotzenrath; H Dralle; B Niederle; P Riss; K Holzer; J Kußmann; A Trupka; T Negele; R Kaderli; E Karakas; F Weber; N Rayes; A Zielke; M Hermann; C Wicke; R Ladurner; C Vorländer; J Waldmann; O Heizmann; S Wächter; S Schopf; W Timmermann; D K Bartsch; R Schmidmaier; M Luster; K W Schmid; M Ketteler; C Dierks; P Schabram; T Steinmüller; K Lorenz Journal: Langenbecks Arch Surg Date: 2021-04-21 Impact factor: 3.445
Authors: Adrien Latge; Sophie Riehm; Michel Vix; Jacob Bani; Mihaela Ignat; Valentin Pretet; Mehdi Helali; Giorgio Treglia; Alessio Imperiale Journal: Diagnostics (Basel) Date: 2021-12-17