Surgical Aspects of Primary Hyperparathyroidism

Parathyroidectomy (PTX) is the treatment of choice for symptomatic primary hyperparathyroidism (PHPT). It is also the treatment of choice in asymptomatic PHPT with evidence for target organ involvement. This review updates surgical aspects of PHPT and proposes the following definitions based on international expert consensus: selective PTX (and reasons for conversion to an extended procedure), bilateral neck exploration for non-localized or multigland disease, subtotal PTX, total PTX with immediate or delayed autotransplantation, and transcervical thymectomy and extended en bloc PTX for parathyroid carcinoma. The systematic literature reviews discussed covered (i) the use of intraoperative PTH (ioPTH) for localized single-gland disease and (ii) the management of low BMD after PTX. Updates based on prospective observational studies are presented concerning PTX for multigland disease and hereditary PHPT syndromes, histopathology, intraoperative adjuncts, localization techniques, perioperative management, “reoperative” surgery and volume/outcome data. Postoperative complications are few and uncommon (<3%) in centers performing over 40 PTXs per year. This review is the first global consensus about surgery in PHPT and reflects the current practice in leading endocrine surgery units worldwide.

Lang, Brian H.Queen Mary Hospital (author)
Farias, Leonardo Costa BandeiraFederal University of São Paulo (author)
Poch, Leyre LorenteAutonomous University of Barcelona (author)
Sywak, MarkUniversity of Sydney (author)
Almquist, MartinLund University,Lunds universitet,Endokrin- och sarkomkirurgi,Forskargrupper vid Lunds universitet,Endocrine and Sarcoma Surgery,Lund University Research Groups,Skåne University Hospital(Swepub:lu)kir-mal (author)
Vriens, Menno R.University Medical Center Utrecht (author)
Yeh, Michael W.University of California, Los Angeles (author)
Shariq, OmairUniversity of Oxford (author)
Duh, Quan YangUniversity of California, San Francisco (author)
Yeh, RandyMemorial Sloan-Kettering Cancer Center (author)
Vu, ThinhUniversity of Texas (author)
LiVolsi, VirginiaUniversity of Pennsylvania (author)
Sitges-Serra, AntonioAutonomous University of Barcelona (author)
University of TexasQueen Mary Hospital (creator_code:org_t)

In:Journal of Bone and Mineral Research: Wiley37:11, s. 2373-23900884-04311523-4681

By the author/editor: Perrier, Nancy; Lang, Brian H.; Farias, Leonardo ...; Poch, Leyre Lore ...; Sywak, Mark; Almquist, Martin; show more...; Vriens, Menno R.; Yeh, Michael W.; Shariq, Omair; Duh, Quan Yang; Yeh, Randy; Vu, Thinh; LiVolsi, Virgini ...; Sitges-Serra, An ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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