Adèle Lecourt1,2, Gwenaëlle Creff3, Paul Coudert3, Olivier De Crouy Chanel3, Pascal Guggenbuhl4, Franck Jegoux3. 1. ENT Department, Rennes University Medical Center, 35000, Rennes, France. franck.jegoux@chu-rennes.fr. 2. Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Rennes, 2 Rue Henri Le Guilloux, 35000, Rennes Cedex, France. franck.jegoux@chu-rennes.fr. 3. ENT Department, Rennes University Medical Center, 35000, Rennes, France. 4. Rheumatologic Department, Rennes University Medical Center, Rennes 1 University, INSERM, Institut NUMECAN (Nutrition Metabolisms and Cancer), 35000, Rennes, France.
Abstract
INTRODUCTION: There is no consensus for management of Mild primary hyperparathyroidism (MILD-pHP). Specific management has been suggested by some authors. We have compared the surgical management of the patients with MILD-pHP to those with Classic primary hyperparathyroidism (C-pHP) treated by surgery according to The Fourth International Workshop on pHP. MATERIALS AND METHODS: Data of 173 patients who underwent a parathyroidectomy were reviewed and retrospectively analysed. Management of 32 patients with MILD-pHPT (18.5%) patients were compared to that of 141 (81.5%) patients with C-pHPT. RESULTS: MILD-pHP group was more often discovered after non-fractured osteoporosis (21.9% vs 7.1%, p = 0.02) and surgery for chondrocalcinosis was more often carried out (6.3% vs 0%, p = 0.03) in the MILD-pHP group. A Mini-Invasive Parathyroidectomy (MIP) was carried out in 81.3% of cases, and 87.5% of patients had a single adenoma. The rate of multiglandular pathology was not different. Same day discharge was significantly higher in MILD-pHP group (37.5% vs 17.7%, p = 0.01). Success was obtained in 87.5% in the MILD-pHP group, there was no significant difference with the C-pHP group (92.9%, p = 0.48). There was no significant difference in the imaging performances. Imaging discordance was observed in 18.8% of cases in MILD-pHP and 33.6% in C-pHP (p = 0.38) without correlation with surgical failure. CONCLUSION: This study suggests that, by selecting patients on the basis of concordant imaging and international recommendations, there is no difference in outcome between MILD-pHP and C-pHP treated surgically.
INTRODUCTION: There is no consensus for management of Mild primary hyperparathyroidism (MILD-pHP). Specific management has been suggested by some authors. We have compared the surgical management of the patients with MILD-pHP to those with Classic primary hyperparathyroidism (C-pHP) treated by surgery according to The Fourth International Workshop on pHP. MATERIALS AND METHODS: Data of 173 patients who underwent a parathyroidectomy were reviewed and retrospectively analysed. Management of 32 patients with MILD-pHPT (18.5%) patients were compared to that of 141 (81.5%) patients with C-pHPT. RESULTS: MILD-pHP group was more often discovered after non-fractured osteoporosis (21.9% vs 7.1%, p = 0.02) and surgery for chondrocalcinosis was more often carried out (6.3% vs 0%, p = 0.03) in the MILD-pHP group. A Mini-Invasive Parathyroidectomy (MIP) was carried out in 81.3% of cases, and 87.5% of patients had a single adenoma. The rate of multiglandular pathology was not different. Same day discharge was significantly higher in MILD-pHP group (37.5% vs 17.7%, p = 0.01). Success was obtained in 87.5% in the MILD-pHP group, there was no significant difference with the C-pHP group (92.9%, p = 0.48). There was no significant difference in the imaging performances. Imaging discordance was observed in 18.8% of cases in MILD-pHP and 33.6% in C-pHP (p = 0.38) without correlation with surgical failure. CONCLUSION: This study suggests that, by selecting patients on the basis of concordant imaging and international recommendations, there is no difference in outcome between MILD-pHP and C-pHP treated surgically.
Authors: Randy Yeh; Yu-Kwang Donovan Tay; Gaia Tabacco; Laurent Dercle; Jennifer H Kuo; Leonardo Bandeira; Catherine McManus; David K Leung; James A Lee; John P Bilezikian Journal: Radiology Date: 2019-03-05 Impact factor: 11.105
Authors: N Singh Ospina; S Maraka; R Rodriguez-Gutierrez; A E Espinosa de Ycaza; S Jasim; M Gionfriddo; A Castaneda-Guarderas; J P Brito; A Al Nofal; P Erwin; R Wermers; V Montori Journal: Osteoporos Int Date: 2016-08-25 Impact factor: 4.507