Document Detail


Impact of preoperative thyroid ultrasonography on the surgical management of primary hyperparathyroidism.
MedLine Citation:
PMID:  18574846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Primary hyperparathyroidism (PHPT) with coexisting thyroid disease has been considered a contraindication to minimally invasive parathyroidectomy (MIP). This study assessed the impact of thyroid ultrasonography and guided fine-needle aspiration (FNA) biopsy with cytological review of the aspiration in distinguishing patients eligible for MIP from those requiring open parathyroidectomy with thyroid surgery. METHODS: The records of 194 consecutive patients who had minimally invasive or open parathyroidectomy for sporadic PHPT were reviewed retrospectively. Thyroid ultrasonographic findings and FNA results were compared with surgical and pathology records. RESULTS: A total of 163 patients (84.0 per cent) were eligible for MIP based on ultrasonographic findings with or without FNA results. Ultrasonography detected concurrent thyroid disease in 163 patients (84.0 per cent). Thirty-nine (23.9 per cent) underwent FNA, of whom 16 had benign findings and were eligible for MIP; the remaining 23 had suspicious FNA results and had open parathyroidectomy combined with thyroid surgery. Postoperative thyroid histopathology confirmed malignancy in nine patients, eight of whom had disease detected ultrasonographically. Micronodular thyroid disease (less than 1 cm) accounted for four of nine malignancies. CONCLUSION: Most patients with PHPT are eligible for MIP. Experienced ultrasonographers can diagnose coexisting micronodular and macronodular thyroid disease, and identify patients eligible for MIP.
Authors:
D P Monroe; B S Edeiken-Monroe; J E Lee; D B Evans; N D Perrier
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  95     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-21     Completed Date:  2008-08-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  957-60     Citation Subset:  AIM; IM    
Copyright Information:
(c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, Texas 77230-1402, USA.
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MeSH Terms
Descriptor/Qualifier:
Biopsy, Fine-Needle
Humans
Hyperparathyroidism, Primary / complications,  pathology,  surgery*,  ultrasonography
Parathyroidectomy / contraindications*
Preoperative Care / methods*
Retrospective Studies
Thyroid Diseases / complications,  pathology,  ultrasonography*
Thyroidectomy / methods*
Ultrasonography, Interventional*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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