Parathyroidectomy is the mainstay of treatment for hyperparathyroidism. Operative
intervention in a previously unexplored neck can yield cure rates greater than 95%
[
1
,
2
]. However, once a patient has undergone neck surgery, such as in the case of failed
parathyroidectomy, reoperation leads to cure rates of only 80% [
3
,
4
]. Similarly, complication rates associated with parathyroidectomy have been found
to be much greater during reoperations than during initial surgeries [
[3]
]. This significantly lower success rate for reoperation combined with the higher complication
rate illustrates the need for a surgeon to achieve eucalcemia at the initial operation.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Advances in SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Six hundred fifty-six consecutive explorations for primary hyperparathyroidism.Ann Surg. 2002; 235 ([discussion: 670–2]): 665-670
- Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy.Surgery. 2005; 138 ([discussion: 587–90]): 583-587
- Profile of a clinical practice: thresholds for surgery and surgical outcomes for patients with primary hyperparathyroidism: a national survey of endocrine surgeons.J Clin Endocrinol Metab. 1998; 83: 2658-2665
- Reoperative parathyroid surgery in the era of sestamibi scanning and intraoperative parathyroid hormone monitoring.Arch Surg. 1999; 134 ([discussion: 704–5]): 699-704
- Parathyroid glands.in: Mulholland M.W. Greenfield’s surgery: scientific principles and practice. 4th edition. Lippincott Williams & Wilkins, Philadelphia (PA)2006
- Diagnosis and management of asymptomatic hyperparathyroidism: safety, efficacy, and deficiencies in our knowledge.J Bone Miner Res. 1991; 6 ([discussion: 151–2]): S135-S142
- Psychologic symptoms before and after parathyroid surgery.Am J Med. 1994; 96: 101-106
- Surgery improves quality of life in patients with “mild” hyperparathyroidism.Am J Surg. 2009; 197: 284-290
- Increased bone mineral density after parathyroidectomy in primary hyperparathyroidism.J Clin Endocrinol Metab. 1995; 80: 729-734
- Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop.J Clin Endocrinol Metab. 2009; 94: 335-339
- Parathyroidectomy in Maryland: effects of an endocrine center.Surgery. 1996; 120 ([discussion: 952–3]): 948-952
- Minimal incision parathyroidectomy: cure, cosmesis, and cost.World J Surg. 2000; 24: 1442-1445
- Hyperparathyroidism.(Available at:) (Accessed October 1, 2010)
- The role of parathyroidectomy in the management of hyperparathyroidism in patients on maintenance haemodialysis and after renal transplantation.Nephron. 1982; 30: 143-148
- Surgical treatment of persistent hyperparathyroidism after renal transplantation.Ann Surg. 2008; 248: 18-30
- Operative treatment of tertiary hyperparathyroidism: a single-center experience.Ann Surg. 1998; 227: 878-886
- Tertiary hyperparathyroidism after renal transplantation: surgical strategy.Surgery. 1998; 124 ([discussion: 683–4]): 677-683
- Avoidable reoperations for thyroid and parathyroid surgery: effect of hospital volume.Surgery. 2008; 144 ([discussion: 906–7]): 899-906
- Remedial parathyroid surgery: changing trends in 130 consecutive cases.Ann Surg. 2006; 244: 471-479
- Investigation of the relationship between volume and mortality for surgical procedures performed in New York State hospitals.JAMA. 1989; 262: 503-510
- Relation of perioperative deaths to hospital volume among patients undergoing pancreatic resection for malignancy.Ann Surg. 1995; 222: 638-645
- The relation between the volume of coronary angioplasty procedures at hospitals treating Medicare beneficiaries and short-term mortality.N Engl J Med. 1994; 331: 1625-1629
- Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery.Surgery. 2007; 142 ([discussion: 887–99]): 887-899
- Operative failures after parathyroidectomy for hyperparathyroidism: the influence of surgical volume.Ann Surg. 2010; 252: 691-695
- Parathyroid hormone venous sampling before reoperative surgery in renal hyperparathyroidism: comparison with noninvasive localization procedures and review of the literature.Arch Surg. 2004; 139: 1331-1338
- High success rate of parathyroid reoperation may be achieved with improved localization diagnosis.World J Surg. 2008; 32 ([discussion: 782–3]): 774-781
- A prospective evaluation of novel methods to intraoperatively distinguish parathyroid tissue utilizing a parathyroid hormone assay.J Surg Res. 2006; 133: 38-41
- Reoperative parathyroidectomy: an algorithm for imaging and monitoring of intraoperative parathyroid hormone levels that results in a successful focused approach.Surgery. 2008; 144 ([discussion: 619–21]): 611-619
- Reoperation for parathyroid adenoma: a contemporary experience.Surgery. 2009; 146: 1144-1155
- Remedial operation for primary hyperparathyroidism.World J Surg. 2009; 33: 2324-2334
- Partial median sternotomy: an attractive approach to mediastinal parathyroid disease.World J Surg. 2006; 30: 1234-1239
- Outpatient video-assisted thoracoscopic surgery (VATS) for ectopic mediastinal parathyroid adenoma: a case report and review of the literature.J Laparoendosc Adv Surg Tech A. 2008; 18: 383-390
- A rising ioPTH level immediately after parathyroid resection: are additional hyperfunctioning glands always present? An application of the Wisconsin Criteria.Ann Surg. 2010; 251: 1127-1130
- Utility of intraoperative PTH for primary hyperparathyroidism due to multigland disease.Ann Surg Oncol. 2009; 16: 3450-3454
- Improved success rate in reoperative parathyroidectomy with intraoperative PTH assay.Ann Surg. 1999; 229 ([discussion: 878–9]): 874-878
- A comprehensive evaluation of perioperative adjuncts during minimally invasive parathyroidectomy: which is most reliable?.Ann Surg. 2005; 242 ([discussion: 380–3]): 375-380
- The 20% rule: a simple, instantaneous radioactivity measurement defines cure and allows elimination of frozen sections and hormone assays during parathyroidectomy.Surgery. 1999; 126 ([discussion: 1028–9]): 1023-1028
- Radioguided reoperative parathyroidectomy for persistent primary hyperparathyroidism.Clin Nucl Med. 2008; 33: 668-670
- Radioguided parathyroidectomy for hyperparathyroidism in the reoperative neck.Surgery. 2009; 146 ([discussion: 598–9]): 592-598
- The effectiveness of radioguided parathyroidectomy in patients with negative technetium tc 99m-sestamibi scans.Arch Surg. 2009; 144: 643-648
Article info
Publication history
Published online: July 13, 2011
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
