Document Detail


Minimally invasive parathyroidectomy without intraoperative parathyroid hormone monitoring in patients with primary hyperparathyroidism.
MedLine Citation:
PMID:  17083106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Minimally invasive parathyroidectomy (MIP) is the preferred operation for patients with primary hyperparathyroidism (HPT) and positive preoperative imaging. This non-randomized case series assessed the long-term results of MIP performed without the use of intraoperative parathyroid hormone (ioPTH) monitoring. METHODS: The study involved prospective collection of demographic, biochemical and operative details on a consecutive, unselected cohort of 298 patients who underwent surgery for non-familial primary HPT during a 5-year interval. The mean preoperative serum calcium level was 3.00 mmol/l with a mean parathyroid hormone concentration of 25.8 pmol/l. (99m)Tc-labelled sestamibi scanning and neck ultrasonography were performed in 262 patients. RESULTS: Sestamibi scan showed unilateral uptake in 182 patients and a single parathyroid adenoma was confirmed on ultrasonography in 161 patients. MIP was performed in 150 patients. The mean duration of operation was 25 (range 8-65) min. Four patients needed conversion to conventional neck exploration. There was one postoperative haematoma and three cases of temporary recurrent laryngeal nerve neuropraxia. All but four patients were normocalcaemic after MIP. All the parathyroid tumours removed were adenomas, with a mean weight of 1.3 (range 0.1-17.4) g. No patient developed recurrent HPT after a median follow-up of 16 (range 3-48) months. CONCLUSION: The outcome of MIP without ioPTH monitoring was comparable to that reported in series that used ioPTH monitoring.
Authors:
R Mihai; F F Palazzo; F V Gleeson; G P Sadler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  94     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-10     Completed Date:  2007-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  42-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Endocrine Surgery, John Radcliffe Hospital, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Calcium / blood
Cohort Studies
Female
Humans
Hyperparathyroidism, Primary / blood,  surgery*
Male
Middle Aged
Monitoring, Intraoperative
Parathyroid Hormone / blood*
Parathyroidectomy / methods*
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/PTH protein, human; 0/Parathyroid Hormone; 7440-70-2/Calcium

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