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PubMed · 15302692

Maximizing outcomes while minimizing exploration in hyperparathyroidism using localization tests.

John A Ryan·Faye T Lee
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Abstract

HYPOTHESIS: Preoperative localization (ultrasonography and scintigraphy) can be used to limit operative exploration in primary hyperparathyroidism while providing a high rate of success. DESIGN: Prospective cohort analysis of 3 types of exploration (1-gland, unilateral, or 4-gland), as directed by localization. RESULTS: In 185 consecutive patients who underwent operations, the final diagnoses were solitary adenoma in 87% and multigland disease in 13%. Ultrasonography (75%) and scintigraphy (83%) demonstrated an enlarged parathyroid gland and, together with operative findings, resulted in 61 1-gland, 63 unilateral, and 61 4-gland explorations, with an initial success rate of 96% and an ultimate success rate of 99%. Limiting exploration resulted in a significant decrease in operative time and hospitalization. CONCLUSION: Localization can limit exploration with success.

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AdenomaAdolescentAdultAgedAged, 80 and overDiagnostic Techniques, SurgicalFemaleHumansHyperparathyroidismMaleMiddle AgedProspective StudiesRadionuclide ImagingThyroid DiseasesThyroid NeoplasmsUltrasonographyJournal Article

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John A Ryan, Faye T Lee. 2004. Maximizing outcomes while minimizing exploration in hyperparathyroidism using localization tests.. https://doi.org/10.1001/archsurg.139.8.838

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