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Surgical Aspects of Primary Hyperparathyroidism

Perrier, Nancy ; Lang, Brian H. ; Farias, Leonardo Costa Bandeira ; Poch, Leyre Lorente ; Sywak, Mark ; Almquist, Martin LU ; Vriens, Menno R. ; Yeh, Michael W. ; Shariq, Omair and Duh, Quan Yang , et al. (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.

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organization
publishing date
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 (&lt;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}},
}