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Titolo:
PARATHYROIDECTOMY IN PRIMARY HYPERPARATHYROIDISM - PREOPERATIVE LOCALIZATION AND ROUTINE BIOPSY OF UNALTERED GLANDS ARE NOT NECESSARY
Autore:
OERTLI D; RICHTER M; KRAENZLIN M; STAUB JJ; OBERHOLZER M; HAAS HG; HARDER F;
Indirizzi:
WASHINGTON UNIV,SCH MED,DEPT SURG,DR NORTONS LAB BIOL THERAPY,CAMPUS BOX 8109,CSRB 3316 ST LOUIS MO 63110 UNIV BASEL HOSP,DEPT SURG,DIV ENDOCRINOL CH-4031 BASEL SWITZERLAND UNIV BASEL HOSP,DEPT INTERNAL MED CH-4031 BASEL SWITZERLAND UNIV BASEL HOSP,GEN SURG SERV CH-4031 BASEL SWITZERLAND UNIV BASEL HOSP,DEPT PATHOL CH-4031 BASEL SWITZERLAND
Titolo Testata:
Surgery
fascicolo: 4, volume: 117, anno: 1995,
pagine: 392 - 396
SICI:
0039-6060(1995)117:4<392:PIPH-P>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARCINOMA; MANAGEMENT; PERSPECTIVE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
D. Oertli et al., "PARATHYROIDECTOMY IN PRIMARY HYPERPARATHYROIDISM - PREOPERATIVE LOCALIZATION AND ROUTINE BIOPSY OF UNALTERED GLANDS ARE NOT NECESSARY", Surgery, 117(4), 1995, pp. 392-396

Abstract

Background. An assessment was made of operative risk and outcome after parathyroidectomy for primary hyperparathyroidism. Methods. A retrospective study was conducted in a single center university hospital in Switzerland The 173 patients (130 women and 43 men) ranged from 17 to 89 years of age (mean, 62.0 years). No routine preoperative localization methods were used for primary neck exploration. Parathyroidectomy was performed under general anesthesia. No routine use was made of intraoperative biopsy of glands whose macroscopic appearance was normal. The 173 patients underwent 179 operations (170 primary and 9 secondary interventions). Resection of a single gland was performed in 127 cases(73.4%) and of two glands in 36 cases (20.8%). Subtotal parathyroidectomy (31/2 glands) was performed in 70 cases (5.8%). Results. Of 170 patients with primary intervention, 164 (96.5%) were normocalcemic after underwent early reexploration. Three additional patients underwent late secondary procedures. These nine secondary operations were successful in seven patients (78%). At follow-up (mean, 24.7 months after operation) normocalcemia was noted in 163 of 171 patients (95.3%). Persistent and recurrent hyperparathyroidism occurred in 1.2% and 3.5% of patients, respectively. Permanent postoperative hypoparathyroidism was noted in 4% (six of Seven patients underwent a subtotal parathyroidectomy for multiglandular hyperplasia). Operative morbidity and mortality were 2.3% and 0.6%, respectively. Conclusions. Our surgical strategy pr treatment of primary hyperparathyroidism has proved to be safe with a favorable outcome in more than 95% of patients. This was possible without the routine use of preoperative localization studies and intraoperative biopsy of macroscopically normal glands. Routine biopsy of normal-appearing glands seems to be unnecessary and may increase the riskof hypoparathyroidism.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 02:18:34