Surgical Aspects of Primary Hyperparathyroidism
(2022) In Journal of Bone and Mineral Research 37(11). p.2373-2390- Abstract
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... (More)
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.
(Less)
- author
- organization
- publishing date
- 2022-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- PARATHYROID-RELATED DISORDERS, PTH/VITAMIN D, THERAPEUTICS-OTHER
- in
- Journal of Bone and Mineral Research
- volume
- 37
- issue
- 11
- pages
- 18 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:36054175
- scopus:85139853667
- ISSN
- 0884-0431
- DOI
- 10.1002/jbmr.4689
- language
- English
- LU publication?
- yes
- id
- 26cd3924-c0fd-4f61-9e91-d3551292d7be
- date added to LUP
- 2023-01-23 08:53:17
- date last changed
- 2024-04-16 11:24:39
@article{26cd3924-c0fd-4f61-9e91-d3551292d7be, abstract = {{<p>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.</p>}}, author = {{Perrier, Nancy and Lang, Brian H. and Farias, Leonardo Costa Bandeira and Poch, Leyre Lorente and Sywak, Mark and Almquist, Martin and Vriens, Menno R. and Yeh, Michael W. and Shariq, Omair and Duh, Quan Yang and Yeh, Randy and Vu, Thinh and LiVolsi, Virginia and Sitges-Serra, Antonio}}, issn = {{0884-0431}}, keywords = {{PARATHYROID-RELATED DISORDERS; PTH/VITAMIN D; THERAPEUTICS-OTHER}}, language = {{eng}}, number = {{11}}, pages = {{2373--2390}}, publisher = {{Wiley-Blackwell}}, series = {{Journal of Bone and Mineral Research}}, title = {{Surgical Aspects of Primary Hyperparathyroidism}}, url = {{http://dx.doi.org/10.1002/jbmr.4689}}, doi = {{10.1002/jbmr.4689}}, volume = {{37}}, year = {{2022}}, }