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Long-term outcome a...
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Norlén, OlovUppsala universitet,Endokrinkirurgi
(författare)
Long-term outcome after parathyroidectomy for lithium-induced hyperparathyroidism
- Artikel/kapitelEngelska2014
Förlag, utgivningsår, omfång ...
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2014-07-15
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Oxford University Press (OUP),2014
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-231983
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-231983URI
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https://doi.org/10.1002/bjs.9589DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Background: The accepted management of lithium-associated hyperparathyroidism (LiHPT) is open four-gland parathyroid exploration (OPTX). This approach has recently been the subject of controversy. A recent study has shown very high long-term recurrence rates after OPTX, whereas some have promoted unilateral focused parathyroidectomy as appropriate management. The aim was to evaluate long-term outcomes after surgery for LiHPT and to assess the accuracy of preoperative imaging. Methods: This was a retrospective cohort study that comprised all patients undergoing initial surgery for LiHPT between 1990 and 2013. The cumulative recurrence rate was calculated by the Kaplan-Meier method. The sensitivity and specificity of sestamibi scintigraphy and ultrasound imaging for identification of single-gland versus multigland disease was investigated using intraoperative assessment as reference. Results: Of 48 patients, 45 had OPTX and three underwent focused parathyroidectomy. Multiglandular disease was documented in 27 patients and 21 had a single adenoma. The median follow-up was 5.9 (range 0.3-22) years and 16 patients died during follow-up. The 10-year cumulative recurrence rate was 16 (95 per cent confidence interval 2 to 29) per cent. No permanent complications occurred after primary surgery for LiHPT. Twenty-four patients had at least one preoperative ultrasound or sestamibi scan. For concordant sestamibi scintigraphy and ultrasound imaging, the sensitivity and specificity for identifying single-gland versus multigland disease was five of nine and five of eight respectively. Conclusion: Surgery provided a safe and effective management option for patients with LiHPT in this series, with a long-term cure rate of well over 80 per cent.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Sidhu, S.
(författare)
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Sywak, M.
(författare)
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Delbridge, L.
(författare)
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Uppsala universitetEndokrinkirurgi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:British Journal of Surgery: Oxford University Press (OUP)101:10, s. 1252-12560007-13231365-2168
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