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Journal articles on the topic 'Parathyroidectomy'

Author: Grafiati
Published: 4 June 2021
Last updated: 10 March 2023

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1

El-Sayed, Yasser, and Atif Abdelatif. "FOCUSED PARATHYROIDECTOMY." Mansoura Medical Journal 33, no. 1 (April 1, 2004): 99–111. http://dx.doi.org/10.21608/mjmu.2004.127430.

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2

Duke, William S., Hampton M. Vernon, and David J. Terris. "Reoperative Parathyroidectomy." Otolaryngology–Head and Neck Surgery 154, no. 2 (November 25, 2015): 268–71. http://dx.doi.org/10.1177/0194599815619625.

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3

Biggar, Magdalena A., and Thomas W. J. Lennard. "Urgent parathyroidectomy." ANZ Journal of Surgery 82, no. 4 (March 21, 2012): 193–94. http://dx.doi.org/10.1111/j.1445-2197.2012.06002.x.

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4

Shepherd, J. "FAILED PARATHYROIDECTOMY." ANZ Journal of Surgery 68, no. 2 (February 1998): 87. http://dx.doi.org/10.1111/j.1445-2197.1998.tb04712.x.

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5

Ikeda, Y., and H. Takami. "Endoscopic parathyroidectomy." Biomedicine & Pharmacotherapy 54 (June 2000): 52s—56s. http://dx.doi.org/10.1016/s0753-3322(00)80011-6.

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6

Simental, Alfred, and Robert L. Ferris. "Reoperative Parathyroidectomy." Otolaryngologic Clinics of North America 41, no. 6 (December 2008): 1269–74. http://dx.doi.org/10.1016/j.otc.2008.05.008.

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7

Assalia, Ahmad, and William B. Inabnet. "Endoscopic parathyroidectomy." Otolaryngologic Clinics of North America 37, no. 4 (August 2004): 871–86. http://dx.doi.org/10.1016/j.otc.2004.02.017.

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8

Irvin, George L. "Quantitative Parathyroidectomy." Mayo Clinic Proceedings 69, no. 6 (June 1994): 605. http://dx.doi.org/10.1016/s0025-6196(12)62258-7.

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9

Silberfein, Eric J. "Reoperative Parathyroidectomy." Archives of Surgery 145, no. 11 (November 15, 2010): 1065. http://dx.doi.org/10.1001/archsurg.2010.230.

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10

Burkey, Shelby H. "Directed Parathyroidectomy." Archives of Surgery 138, no. 6 (June 1, 2003): 604. http://dx.doi.org/10.1001/archsurg.138.6.604.

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11

Okoh, Alexis Kofi, Sara Sound, and Eren Berber. "Robotic parathyroidectomy." Journal of Surgical Oncology 112, no. 3 (June 12, 2015): 240–42. http://dx.doi.org/10.1002/jso.23911.

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12

Hone, R. W. A., T. Tikka, A. I. Kaleva, A. Hoey, V. Alexander, A. Balfour, and I. J. Nixon. "Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery." Journal of Laryngology & Otology 130, no. 7 (June 10, 2016): 669–73. http://dx.doi.org/10.1017/s0022215116008136.

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AbstractBackground:Inadvertent (or incidental) parathyroidectomy can occur during thyroidectomy. However, the factors associated with inadvertent parathyroidectomy remain unclear. This study aimed to report the rate of inadvertent parathyroidectomy during thyroidectomy and associated risk factors.Methods:Variables including fine needle aspiration cytology findings, age, sex, thyroid weight, concurrent neck dissection, extent of thyroidectomy, and the presence of cancer and parathyroid tissue within the specimen were recorded for 266 patients. The incidence of post-operative hypocalcaemia was also recorded. Univariate and multivariate analysis were performed to identify factors associated with inadvertent parathyroidectomy.Results:The inadvertent parathyroidectomy rate was 16 per cent. Univariate analysis revealed that cancer and concurrent neck dissection predicted inadvertent parathyroidectomy. On multivariate analysis, only concurrent neck dissection remained an independent predictor of inadvertent parathyroidectomy: it was associated with a fourfold increase in inadvertent parathyroidectomy.Conclusion:The inadvertent parathyroidectomy rate was 16 per cent and concurrent neck dissection was identified as an independent predictor of inadvertent parathyroidectomy.
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Izkhakov, Neriy, Heranmaye Prasad, Nicholas John Vernetti, and Samer Nakhle. "Successful Parathyroidectomy May Not Resolve Hypercalciuria in Patients With Primary Hyperparathyroidism." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A226. http://dx.doi.org/10.1210/jendso/bvab048.459.

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Abstract Background: Hypercalciuria, with twenty-four-hour urinary calcium of >400 mg/day, is one of the indications for parathyroidectomy in patients with primary hyperparathyroidism. We report five cases where hypercalciuria is not resolved following a successful parathyroidectomy (normalization of serum calcium) in such patients. Here resolution of hypercalciuria is defined as twenty-four-hour urinary calcium of less than 200 mg/day. Clinical Case: This is a case series of five patients who remained hypercalciuric at 6 to 19 months after successful parathyroidectomy. Pre-parathyroidectomy, average PTH was 95 pg/dL (Min 69 pg/dL, Max 120 pg/dL), average serum calcium was 11.0 mg/dL (min 10.3 mg/dL, max 12.0 mg/dL), and average twenty-four-hour urinary calcium was 455 mg/day (min 386 mg/day, max 551 mg/day). Calcium levels were corrected to normal range post-parathyroidectomy and remained in normal range. However, hypercalciuria did not resolve. Post-parathyroidectomy, average PTH was 44 pg/dL (min 25 pg/dL, max 69 pg/dL), average serum calcium was 9.6 mg/dL (min 9.3 mg/dL, max 9.8 mg/dL), and average twenty-four-hour urinary calcium was 284 mg/day (min 201 mg/day, max 376 mg/day). Two patients who had history of nephrolithiasis prior to parathyroidectomy continued to develop nephrolithiasis at six and sixteen months after successful parathyroidectomy. Conclusions: This case series showed that hypercalciuria may not resolve following a successful parathyroidectomy in patients with primary hyperparathyroidism and elevated twenty-four-hour urinary calcium at 6 to 19 months after surgery. Further observations to evaluate long term effects of parathyroidectomy on hypercalciuria is needed.
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14

Anderson, Jamie E., Jennifer L. Olson, and Michael J. Campbell. "Parathyroidectomy in Dialysis Patients: What is the Risk?" World Journal of Endocrine Surgery 8, no. 3 (2016): 193–98. http://dx.doi.org/10.5005/jp-journals-10002-1190.

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ABSTRACT Aims Patients with chronic kidney disease (CKD) on dialysis commonly develop hyperparathyroidism (HPT), but are often not referred for surgical evaluation because of the belief that the cardiopulmonary risks of a parathyroidectomy are prohibitively high. Previous studies have not adequately determined the surgical risks of parathyroidectomy in this population. Materials and methods We used the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013 to evaluate risk of complications for dialysis vs nondialysis patients undergoing parathyroidectomy using univariate and multivariate logistic regressions. We also compared outcomes between dialysis patients undergoing parathyroidectomy and arteriovenous fistula (AVF) creation to understand the relative risk between these procedures. Results A total of 28,438 patients underwent parathyroidectomy; 1,833 (6.5%) were on dialysis. Among patients undergoing parathyroidectomy, unadjusted mortality and complication rates were higher for patients on dialysis compared to those not on dialysis (1.4% vs 0.1%, p < 0.001; 7.9% vs 1.4%, p < 0.001). Multivariate analysis found increased odds of mortality, all complications, and cardiopulmonary complications among patients on dialysis compared to those not on dialysis [odds ratio (OR) 5.28, p = 0.004; 2.10, p < 0.001; 5.14, p < 0.001]. When compared to patients undergoing parathyroidectomy, dialysis patients undergoing AVF had no difference in odds of death (p = 0.392) or cardiopulmonary complications (p = 0.138), but did have an increased risk of any complication (OR 1.66, p = 0.035). Conclusion Dialysis patients undergoing parathyroidectomy have an increased risk of cardiopulmonary complications and mortality compared to patients not on dialysis; however, these risks are similar to patients undergoing AVF creation. The risks of parathyroidectomy in dialysis patients are likely similar to other commonly performed procedures for dialysis patients. Clinical significance: The risk of mortality and complications should be discussed during informed consent with dialysis patients undergoing parathyroidectomy. These findings can also assist in preoperative risk assessments. How to cite this article Anderson JE, Olson JL, Campbell MJ. Parathyroidectomy in Dialysis Patients: What is the Risk? World J Endoc Surg 2016;8(3):193-198.
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15

de la Cruz Rodríguez, Iván Emilio, Elsy Sarahí García Montesinos, María Fernanda Rodríguez-Delgado, Guadalupe Vargas Ortega, Lourdes Balcázar Hernández, Victoria Mendoza Zubieta, Victor Hernández Avendaño, and Baldomero González Virla. "Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism." Case Reports in Endocrinology 2021 (April 23, 2021): 1–4. http://dx.doi.org/10.1155/2021/5556977.

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Introduction. Parathyroidectomy is the curative treatment option in primary hyperparathyroidism (PHPT). The decrease of parathormone (PTH) by 50% or more from levels prior to surgery after excision predicts successful parathyroidectomy. Serum calcium is expected to return to normal within 24–72 hours after the surgery; however, nearly 10% have transient, persistent postoperative hypercalcemia. We present a case report of delayed calcium normalization after successful parathyroidectomy in a 38-year-old patient with PHPT. Methods. Parathyroidectomy was performed, with evidence of a decrease in PTH levels of more than 50% in the first 24 hours postoperatively compared to presurgical PTH; however, despite curative parathyroidectomy, a delayed calcium normalization was evidenced, with hypercalcemia persistence up to 120 hours postoperatively. Results. After the first month postoperatively, serum calcium remained normal. In conclusion, approximately 10% of patients with curative parathyroidectomy have transient, persistent postoperative hypercalcemia, which is more likely to occur in patients with higher preoperative serum calcium and PTH levels. Conclusion. Persistent hypercalcemia after the first month postoperatively is related with persistent PHPT, highlighting the importance of calcium monitoring after parathyroidectomy to predict short-term, medium-term, and long-term outcomes and prognosis.
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16

Kotelnikova, L. P., G. Yu Mokina, and N. G. Polyakova. "HYPOCALCEMIA AFTER PARATHYROIDECTOMY." Tavricheskiy Mediko-Biologicheskiy Vestnik 23, no. 2 (2020): 75–79. http://dx.doi.org/10.37279/2070-8092-2020-23-2-75-79.

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The aim of the study was to estimate the frequency and timing of hypocalcemia after surgical treatment for primary, secondary and tertiary hyperparathyroidism. Materials and methods. 21 patients were operated for hyperparathyroidism, 15 - for primary (group 1), 6 - for secondary and tertiary (group 2). In I group the median baseline level of total serum calcium was 3.06 mmol/l, phosphorus0.9 mmol/l, and parathyroid hormone360 pmol/l. In II group all patients were on program dialysis for end-stage chronic kidney failure for at least five years. The median baseline serum total calcium level was 2.29 mmol/l, phosphorus2.64 mmol/l, and parathyroid hormone-1822 pmol/l. Results. A day after removal of the parathyroid adenoma (1 group) the level of calcium and phosphorus was normalized, the content of parathyroid hormone (median 21.4 pmol/l) significantly decreased. In one case (6.7%) on the fifth day there were clinical signs of hypocalcemia and the level of calcium decreased to 1.86 mmol/l. All patients of the second group underwent subtotal parathyroidectomy. After a day the level of parathyroid hormone significantly decreased (median227 pmol/l). The phosphorus content has returned to normal. The calcium level in all cases exceeded 2 mmol/l. On day 4-5 the total calcium content decreased and ranged from 1.14 mmol/l to 2.04 mmol/l. Four patients (66,7%) showed clinical signs of hypocalcemia. It was found that the development of hypocalcemia has a positive correlation of average value with the level of parathyroid hormone, phosphorus and negative with the content of calcium before surgery. Conclusion. The decrease in the level of total calcium with the development of clinical symptoms occurs on 4-5 days after surgery for primary hyperparathyroidism in 6.7% and for secondary or tertiary - in 66.7%. Risk factors for hypocalcemia are the baseline low level of calcium and high of parathyroid hormone, phosphorus.
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17

Kotelnikova, L. P., G. Yu Mokina, and N. G. Polyakova. "HYPOCALCEMIA AFTER PARATHYROIDECTOMY." Tavricheskiy Mediko-Biologicheskiy Vestnik 23, no. 2 (2020): 75–79. http://dx.doi.org/10.37279/2070-8092-2020-23-2-75-79.

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The aim of the study was to estimate the frequency and timing of hypocalcemia after surgical treatment for primary, secondary and tertiary hyperparathyroidism. Materials and methods. 21 patients were operated for hyperparathyroidism, 15 - for primary (group 1), 6 - for secondary and tertiary (group 2). In I group the median baseline level of total serum calcium was 3.06 mmol/l, phosphorus0.9 mmol/l, and parathyroid hormone360 pmol/l. In II group all patients were on program dialysis for end-stage chronic kidney failure for at least five years. The median baseline serum total calcium level was 2.29 mmol/l, phosphorus2.64 mmol/l, and parathyroid hormone-1822 pmol/l. Results. A day after removal of the parathyroid adenoma (1 group) the level of calcium and phosphorus was normalized, the content of parathyroid hormone (median 21.4 pmol/l) significantly decreased. In one case (6.7%) on the fifth day there were clinical signs of hypocalcemia and the level of calcium decreased to 1.86 mmol/l. All patients of the second group underwent subtotal parathyroidectomy. After a day the level of parathyroid hormone significantly decreased (median227 pmol/l). The phosphorus content has returned to normal. The calcium level in all cases exceeded 2 mmol/l. On day 4-5 the total calcium content decreased and ranged from 1.14 mmol/l to 2.04 mmol/l. Four patients (66,7%) showed clinical signs of hypocalcemia. It was found that the development of hypocalcemia has a positive correlation of average value with the level of parathyroid hormone, phosphorus and negative with the content of calcium before surgery. Conclusion. The decrease in the level of total calcium with the development of clinical symptoms occurs on 4-5 days after surgery for primary hyperparathyroidism in 6.7% and for secondary or tertiary - in 66.7%. Risk factors for hypocalcemia are the baseline low level of calcium and high of parathyroid hormone, phosphorus.
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18

Mohsin, Khuzema, Hassan Alzahrani, Daniah Bu Ali, Sang-Wook Kang, and Emad Kandil. "Robotic transaxillary parathyroidectomy." Gland Surgery 6, no. 4 (August 2017): 410–11. http://dx.doi.org/10.21037/gs.2017.04.09.

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19

Komaba, Hirotaka, Michio Nakamura, and Masafumi Fukagawa. "Resurgence of parathyroidectomy." Current Opinion in Nephrology and Hypertension 26, no. 4 (July 2017): 243–49. http://dx.doi.org/10.1097/mnh.0000000000000326.

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20

Tolley, Neil, Asit Arora, Fausto Palazzo, George Garas, Ranju Dhawan, Jeremy Cox, and Ara Darzi. "Robotic-Assisted Parathyroidectomy." Otolaryngology–Head and Neck Surgery 144, no. 6 (May 5, 2011): 859–66. http://dx.doi.org/10.1177/0194599811402152.

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21

Palazzo, F. Fausto, and Gregory P. Sadler. "Minimally invasive parathyroidectomy." BMJ 328, no. 7444 (April 8, 2004): 849–50. http://dx.doi.org/10.1136/bmj.328.7444.849.

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22

Starker, Lee F., Annabelle L. Fonseca, Tobias Carling, and Robert Udelsman. "Minimally Invasive Parathyroidectomy." International Journal of Endocrinology 2011 (2011): 1–8. http://dx.doi.org/10.1155/2011/206502.

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Minimally invasive parathyroidectomy (MIP) is an operative approach for the treatment of primary hyperparathyroidism (pHPT). Currently, routine use of improved preoperative localization studies, cervical block anesthesia in the conscious patient, and intraoperative parathyroid hormone analyses aid in guiding surgical therapy. MIP requires less surgical dissection causing decreased trauma to tissues, can be performed safely in the ambulatory setting, and is at least as effective as standard cervical exploration. This paper reviews advances in preoperative localization, anesthetic techniques, and intraoperative management of patients undergoing MIP for the treatment of pHPT.
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23

Espiritu, Rachel, and Diana Dean. "Parathyroidectomy-Induced Thyroiditis." Endocrine Practice 16, no. 4 (July 2010): 656–59. http://dx.doi.org/10.4158/ep09367.cr.

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Tolley, Neil, George Garas, Ranju Dhawan, Jeremy Cox, and Fausto Palazzo. "Robotic Assisted Parathyroidectomy." Otolaryngology–Head and Neck Surgery 143, no. 2_suppl (August 2010): P71—P72. http://dx.doi.org/10.1016/j.otohns.2010.06.098.

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Bu Ali, Daniah, Fadi Murad, Sang-Wook Kang, and Emad Kandil. "Robot-assisted parathyroidectomy." Operative Techniques in Otolaryngology-Head and Neck Surgery 27, no. 3 (September 2016): 167–71. http://dx.doi.org/10.1016/j.otot.2016.06.001.

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26

Shah-Becker, Shivani, and David Goldenberg. "Minimally invasive parathyroidectomy." Operative Techniques in Otolaryngology-Head and Neck Surgery 27, no. 3 (September 2016): 152–56. http://dx.doi.org/10.1016/j.otot.2016.06.008.

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Sosa, Julie Ann, and Robert Udelsman. "Minimally invasive parathyroidectomy." Surgical Oncology 12, no. 2 (August 2003): 125–34. http://dx.doi.org/10.1016/s0960-7404(03)00041-0.

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28

Karmegam, Sathish, and Anupkumar Shetty. "Calciphylaxis after parathyroidectomy." Hemodialysis International 21 (October 2017): S62—S66. http://dx.doi.org/10.1111/hdi.12599.

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29

Prinz, Richard A. "Parathyroidectomy and More." Mayo Clinic Proceedings 66, no. 7 (July 1991): 756–59. http://dx.doi.org/10.1016/s0025-6196(12)62090-4.

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30

Saxe, Andrew. "Advances in parathyroidectomy." Current Surgery 58, no. 4 (July 2001): 349–53. http://dx.doi.org/10.1016/s0149-7944(00)00407-4.

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31

Cohen, Eric P., and John E. Moulder. "Parathyroidectomy in ESRD." Kidney International 66, no. 1 (July 2004): 459. http://dx.doi.org/10.1111/j.1523-1755.2004.669_1.x.

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32

Ellis, Harold. "The first parathyroidectomy." British Journal of Hospital Medicine 66, no. 6 (June 2005): 361. http://dx.doi.org/10.12968/hmed.2005.66.6.18406.

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33

Yaqoob, M., R. Ahmad, and E. Simkin. "Hypocalcaemia after parathyroidectomy." BMJ 296, no. 6630 (April 23, 1988): 1198. http://dx.doi.org/10.1136/bmj.296.6630.1198-a.

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34

Hussain, Sabba A. "Parathyroidectomy and Hypertension." JAMA Surgery 155, no. 6 (June 1, 2020): 531. http://dx.doi.org/10.1001/jamasurg.2019.6358.

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Vaid, Sachin. "Minimally Invasive Parathyroidectomy." Archives of Surgery 146, no. 7 (July 1, 2011): 876. http://dx.doi.org/10.1001/archsurg.2011.155.

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Smith, Nicholas, Jeffrey Scott Magnuson, David Macy Vidrine, Brian Kulbersh, and Glenn E. Peters. "Minimally Invasive Parathyroidectomy." Archives of Otolaryngology–Head & Neck Surgery 135, no. 11 (November 1, 2009): 1108. http://dx.doi.org/10.1001/archoto.2009.160.

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37

London, N. J. M., D. M. Lloyd, H. Pearson, J. P. Neoptolemos, and P. R. F. Bell. "Pancreatitis after parathyroidectomy." British Journal of Surgery 73, no. 9 (September 1986): 766–67. http://dx.doi.org/10.1002/bjs.1800730931.

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38

Manatakis, Dimitrios K., Dimitrios Balalis, Vasiliki N. Soulou, Dimitrios P. Korkolis, Georgios Plataniotis, and Emmanouil Gontikakis. "Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences." International Journal of Endocrinology 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/7825305.

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Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors.Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia), pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy), and biochemical (serum calcium and phosphate levels) factors.Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p=0.003). Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p=0.49). Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups.Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.
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Alimoğulları, Mustafa, and Hakan Buluş. "Conventional parathyroidectomy versus noninstrumental minimally invasive parathyroidectomy in parathyroid adenoma." Medical Journal of Islamic World Academy of Sciences 27, no. 2 (2019): 44–49. http://dx.doi.org/10.5505/ias.2019.58826.

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Sahyouni, Grace, Beth Osterbauer, Soyun Park, Connie Paik, Juliana Austin, Gabriel Gomez, and Daniel Kwon. "Rate of Incidental Parathyroidectomy in a Pediatric Population." OTO Open 5, no. 4 (October 2021): 2473974X2110590. http://dx.doi.org/10.1177/2473974x211059070.

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Objective Incidental parathyroidectomy is a relatively common occurrence in thyroid surgery, which may lead to hypoparathyroidism and postoperative hypocalcemia, but it is not well studied in children. The objectives of this study were to determine the rate of incidental parathyroidectomy, identify potential risk factors, and investigate postoperative complications in children undergoing thyroidectomy. Study Design Retrospective cohort study. Setting Patients who underwent thyroidectomy over a 10-year period at a tertiary children’s hospital. Methods Pathology reports were reviewed to determine incidental parathyroid gland tissue. Additional data collected included patient demographics, type of procedure, underlying thyroid pathology, as well as immediate and long-term postoperative clinical outcomes. Results Of 209 patients, 65 (31%) had incidental parathyroidectomy. Several variables were associated with incidental parathyroidectomy on univariable analysis. However, in the final multivariable model, only thyroidectomy with lymph node dissection was associated with increased odds of having incidental parathyroidectomy (odds ratio, 3.3; P = .04; 95% CI, 1.1-9.8). After a median follow up of 1 year, a significantly higher percentage of patients with incidental parathyroidectomy had evidence of long-term hypoparathyroidism (9/62 [15%] vs 3/144 [2%], P = .001). Conclusion Incidental parathyroidectomy was relatively common in our pediatric thyroidectomy population, which may be a result of several anatomic, clinical, and surgeon-related factors. Close attention to parathyroid preservation with meticulous surgical technique is the most practical method of preventing long-term hypoparathyroidism and hypocalcemia.
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41

Nalbo, Dinesh, Divya Dahiya, Ashwani Sood, Sanjay Kumar Bhadada, Arunanshu Behera, and Uma Nahar. "Surgical outcome of radioguided parathyroidectomy in primary hyperparathyroidism." International Surgery Journal 8, no. 2 (January 29, 2021): 681. http://dx.doi.org/10.18203/2349-2902.isj20210384.

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Background: Focused parathyroidectomy is the adequate treatment for primary hyperparathyroidism for localised disease. Adequacy of resection is confirmed by the availability of intraoperative parathormone assay (iOPTH). In the absence of availability of iOPTH assay, the radio guided surgery is an option. The aim of this study was to evaluate the feasibility of radioguided parathyroidectomy in tertiary care centre in India and to compare the overall success rate, operative time, hospital stay and postoperative outcome between focused open and radioguided parathyroidectomy.Methods: This was a prospective study which included 30 primary hyperparathyroidism patients with a single gland disease localised on Tc99m Sesta MIBI scan. Patients were randomized into two equal groups, and they underwent focused open or radioguided parathyroidectomy. Patients were followed up for three months.Results: All patients achieved biochemical cure as evident by the normalization of serum calcium and parathormone levels after surgery. The mean incision length, and operative time in this study was significantly better for radioguided parathyroidectomy (p=0.0001, <0.0001 respectively). There was no perioperative complications like recurrent laryngeal nerve injury, gland rupture, or bleeding in either group. However, there seems to be higher grade of pain experience by the patients who underwent open focused parathyroidectomy (p<0.0001).Conclusions: Radioguided parathyroidectomy has excellent cure rate for PHPT with an added advantage of short operative time & incision length and less post-operative pain. Radioguided parathyroidectomy seems to be a good alternative in the absence of availability of iOPTH assay and frozen section.
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Dahiya, Divya, Kishore Abuji, Poonam Kumari, Akanksha Gautam, Sanjay Bhadada, Ashwani Sood, Uma Nahar, Cherring Tandup, and Arunanshu Behera. "Surgical outcome after focused parathyroidectomy: an experience from a tertiary care center in north India." Polish Journal of Surgery 93, no. 5 (May 15, 2021): 1–5. http://dx.doi.org/10.5604/01.3001.0014.8864.

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Introduction: Focused parathyroidectomy is the gold standard treatment for primary hyperparathyroidism (PHPT) due to single gland disease with comparable success rate as that of conventional four gland exploration. It is also associated with fewer surgical complications. Despite these benefits, there is still controversy about the high recurrence following focused approach. Therefore the aim was to analyse our experience in terms of success rate of focused parathyroidectomy for PHPT. Methods: This was a retrospective analysis of 192 patients of PHPT between January 2017 and August 2020 who underwent focused parathyroidectomy without iOPTH analysis; and had a minimum follow up of six months. Demographic profile, biochemical (pre and postoperative), radiological, operative and histological detail of all patients was recorded. Parathyroidectomy was considered curative if patient maintained normal serum calcium and PTH levels six months after surgery. Persistent hyperparathyroidism was considered if hypercalcemia or high PTH levels persisted; or recurrent disease when patient had rising serum calcium and / or PTH levels six months after curative parathyroidectomy. Results: No patient had pain and wound related complications after parathyroidectomy. Two patients had voice change in the immediate postoperative period which recovered subsequently; no patient had documented vocal cord paralysis. Persistent disease was present in two patients; both required neck exploration. Four patients had recurrence of PHPT within 6 months of parathyroidectomy; all of them had hyperplasia on the final biopsy. The overall cure rate was 97.92%. Conclusion: Therefore, we recommend focused surgery for sporadic PHPT with acceptable recurrence rate and surgical complications.
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Crea, Nicola, Giacomo Pata, Claudio Casella, Carlo Cappelli, and Bruno Salerni. "Predictive Factors for Postoperative Severe Hypocalcaemia after Parathyroidectomy for Primary Hyperparathyroidism." American Surgeon 78, no. 3 (March 2012): 352–58. http://dx.doi.org/10.1177/000313481207800347.

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Hypocalcaemia is a complication of parathyroidectomy. We retrospectively analyzed data on patients who underwent parathyroidectomy for primary hyperparathyroidism (pHPT) to identify predictive factors for severe postoperative hypocalcaemia. Since 2004 we performed 87 parathyroidectomies for pHPT. We divided the patients into two groups: subjects who presented with postoperative hypocalcaemia (group B) or otherwise (group A). We looked for a correlation between several variables and the incidence of postoperative hypocalcaemia. The median calcemia in group B (19 patients) was 6.9 mg/dL on the first postoperative day and 7.6 mg/dL on the third day. We observed hypocalcemia related clinical symptoms in every patient. In all 19 cases the reduction of intraoperative parathyroid hormone above 85 per cent after parathyroidectomy was related to the development of severe postoperative hypocalcaemia ( P = 0.042). We found that the reduction of intraoperative parathyroid hormone over 85 per cent after parathyroidectomy can be considered a reliable predictive factor of postoperative hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.
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Frey, Samuel, Raphaël Bourgade, Cédric Le May, Mikaël Croyal, Edith Bigot-Corbel, Nelly Renaud-Moreau, Matthieu Wargny, et al. "Effect of Parathyroidectomy on Metabolic Homeostasis in Primary Hyperparathyroidism." Journal of Clinical Medicine 11, no. 5 (March 2, 2022): 1373. http://dx.doi.org/10.3390/jcm11051373.

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Background: The benefits of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism (PHPT) are controversial. This monocentric, observational, prospective study aimed to assess the effects of parathyroidectomy on glucose and lipid metabolism in classic or mild PHPT. Methods: Patients who underwent parathyroidectomy for classic (calcemia >2.85 mmol/L) or mild PHPT (calcemia ≤2.85 mmol/L) between 2016 and 2019 were included. A metabolic assessment was performed before and 1 year after parathyroidectomy. Patients with a history of diabetes were excluded. Results: Nineteen patients had classic and 120 had mild PHPT. Ninety-five percent were normocalcemic 6 months after surgery. Fasting plasma glucose and insulin levels decreased after parathyroidectomy in patients with mild PHPT (p < 0.001). HOMA-IR decreased after surgery in the overall population (p < 0.001), while plasma adiponectin concentrations increased in patients with both classic (p = 0.005) and mild PHPT (p < 0.001). Plasma triglyceride levels decreased significantly only in patients with classic PHPT (p = 0.021). Plasma PCSK9 levels decreased in patients with mild PHPT (p < 0.001). Conclusions: Parathyroidectomy for PHPT improves insulin resistance and decreases plasma triglyceride levels in classic PHPT and plasma PCSK9 levels in mild PHPT. Further studies are needed to better characterize the consequences of such metabolic risk factors’ improvements on cardiovascular events.
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Ma, Tsung-Liang, Peir-Haur Hung, Ing-Ching Jong, Chih-Yen Hiao, Yueh-Han Hsu, Pei-Chun Chiang, How-Ran Guo, and Kuan-Yu Hung. "Parathyroidectomy Is Associated with Reduced Mortality in Hemodialysis Patients with Secondary Hyperparathyroidism." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/639587.

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Secondary hyperparathyroidism increases morbidity and mortality in hemodialysis patients. The Kidney Disease Outcomes Quality Initiative Guidelines recommend parathyroidectomy for patients with chronic kidney disease and parathyroid hormone concentrations exceeding 800 pg/mL; however, this concentration represents an arbitrary cut-off value. The present study was conducted to identify factors influencing mortality in hemodialysis patients with parathyroid hormone concentrations exceeding 800 pg/mL and to evaluate the effects of parathyroidectomy on outcome for these patients. Two hundred twenty-one hemodialysis patients with parathyroid hormone concentrations > 800 pg/mL from July 2004 to June 2010 were identified. 21.1% of patients (n = 60) received parathyroidectomy and 14.9% of patients (n = 33) died during a mean follow-up of 36 months. Patients with parathyroidectomy were found to have lower all-cause mortality (adjusted hazard ratio [aHR]: 0.34). Other independent predictors included age ≥ 65 years (aHR: 2.11) and diabetes mellitus (aHR: 3.80). For cardiovascular mortality, parathyroidectomy was associated with lower mortality (HR = 0.31) but with a marginal statistical significance (p = 0.061). In multivariate analysis, diabetes was the only significant predictor (aHR: 3.14). It is concluded that, for hemodialysis patients with parathyroid hormone concentrations greater than 800 pg/mL, parathyroidectomy is associated with reduced all-cause mortality.
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Hsieh, Ting-Min, Cheuk-Kwan Sun, Yen-Ta Chen, and Fong-Fu Chou. "Total Parathyroidectomy versus Subtotal Parathyroidectomy in the Treatment of Tertiary Hyperparathyroidism." American Surgeon 78, no. 5 (May 2012): 600–606. http://dx.doi.org/10.1177/000313481207800544.

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The purposes of this study are to evaluate the merits of surgical treatment, including subtotal parathyroidectomy (SP) and total parathyroidectomy (TP), in patients with tertiary hyperparathyroidism (THPT) and compare the outcome of the two surgical options. Medical records of patients undergoing parathyroidectomy for THPT were retrospectively reviewed and long-term outcomes between the two groups were compared. Fourteen out of 488 renal transplantation recipients required parathyroidectomy for THPT during a 24-year follow-up period with a median follow-up of 35.5 [interquartile range (IQR), 19.3–133.3] months. All patients had hypercalcemia, whereas 13 had varying symptoms and one was asymptomatic. Median serum calcium level decreased from 12.4 (IQR, 11.9–12.6) mg/dL preoperatively to 8.9 (IQR, 8.1–9.4) mg/dL postoperatively ( P = 0.001), whereas median intact parathyroid hormone (iPTH) dropped from a preoperative level of 340.5 (IQR, 247–540) pg/mL to 55.1 (IQR, 24.4–66.4) pg/mL after surgery ( P = 0.018). Comparison between patients receiving TP and SP revealed no difference in incidence of recurrence or permanent complications, whereas the former had significantly lower calcium levels ( P = 0.048) and higher phosphorus levels ( P = 0.017) compared with the latter. Moreover, a significant reduction in calcium level was noted in TP group on long-term follow-up compared with their immediately postoperative level (8.1 vs 9.0 mg/dL, respectively, P < 0.05), whereas there was no significant decrease in SP group. We concluded that parathyroidectomy is efficient and safe in treating THPT. Because TP would increase the risk of hypocalcemia, a less radical procedure (SP) is preferred.
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Ryan, M. F., S. R. Jones, and A. D. Barnes. "Clinical Evaluation of a Rapid Parathyroid Hormone Assay." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 29, no. 1 (January 1992): 48–51. http://dx.doi.org/10.1177/000456329202900106.

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Modifications to the incubation conditions of radioimmunoradiometric assay for whole molecule parathyroid hormone (PTH) permit accurate quantification of the hormone in the peripheral circulation within 1 h of sampling. We assessed the assay intraoperatively in 75 patients undergoing parathyroidectomy. Serum PTH concentration declined to less than 20% of its pre-operative value within 20 min of the successful completion of surgery provided that renal function was normal. In patients with chronic renal failure the rate of decline in serum PTH concentration after parathyroidectomy was slower in some cases. In four cases of unsuccessful parathyroidectomy, serum PTH concentration remained above 60% of its pre-operative value. Intraoperative monitoring during parathyroidectomy using this rapid PTH assay offers considerable advantages to the surgeon over frozen section.
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Almquist, Martin, Elin Isaksson, and Naomi Clyne. "The treatment of renal hyperparathyroidism." Endocrine-Related Cancer 27, no. 1 (January 2020): R21—R34. http://dx.doi.org/10.1530/erc-19-0284.

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Renal hyperparathyroidism (rHPT) is a complex and challenging disorder. It develops early in the course of renal failure and is associated with increased risks of fractures, cardiovascular disease and death. It is treated medically, but when medical therapy cannot control the hyperparathyroidism, surgical parathyroidectomy is an option. In this review, we summarize the pathophysiology, diagnosis, and medical treatment; we describe the effects of renal transplantation; and discuss the indications and strategies in parathyroidectomy for rHPT. Renal hyperparathyroidism develops early in renal failure, mainly as a consequence of lower levels of vitamin D, hypocalcemia, diminished excretion of phosphate and inability to activate vitamin D. Treatment consists of supplying vitamin D and reducing phosphate intake. In later stages calcimimetics might be added. RHPT refractory to medical treatment can be managed surgically with parathyroidectomy. Risks of surgery are small but not negligible. Parathyroidectomy should likely not be too radical, especially if the patient is a candidate for future renal transplantation. Subtotal or total parathyroidectomy with autotransplantation are recognized surgical options. Renal transplantation improves rHPT but does not cure it.
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Tachamo, Niranjan, Bidhya Timilsina, Rashmi Dhital, Theresa Lynn, Vasudev Magaji, and Ilan Gabriely. "Primary Hyperparathyroidism in Pregnancy: Successful Parathyroidectomy during First Trimester." Case Reports in Endocrinology 2018 (August 6, 2018): 1–4. http://dx.doi.org/10.1155/2018/5493917.

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Primary hyperparathyroidism in pregnancy can result in significant maternal and fetal complications. When indicated, prompt parathyroidectomy in the early second trimester is considered the treatment of choice. Pregnant patients with primary hyperparathyroidism who have an indication for parathyroidectomy during the first trimester represent a therapeutic challenge. We present the case of a 32-year-old primigravida who presented with symptomatic hypercalcemia from her primary hyperparathyroidism. She remained symptomatic despite aggressive conservative management and underwent parathyroidectomy in her first trimester with excellent outcomes.
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Tregunna, Rebecca. "Persistent hypercalciuria after parathyroidectomy." Nature Reviews Urology 18, no. 4 (March 10, 2021): 190. http://dx.doi.org/10.1038/s41585-021-00454-4.

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