Initial parathyroid exploration: current trends in Australia.

S N Sinha; P Subramaniam

doi:10.1111/j.1445-2197.1996.tb01185.x

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PubMed · 8634042

Initial parathyroid exploration: current trends in Australia.

S N Sinha·P Subramaniam

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Abstract

BACKGROUND: An Australia-wide multicentre prospective study was undertaken to audit cases of initial parathyroid exploration between 1 January and 31 December 1992. One hundred and sixty-two cases were audited. The audit was designed to study pre-operative biochemical assessment, localization techniques and the technique of exploration. METHOD: A pro forma audit form was circulated to all Australian surgeons known to perform parathyroid surgery. Eleven responded. RESULTS: Free serum ionized calcium (iCa) was measured in 30% of cases, with the majority of pre-operative calcium assays being performed using total serum calcium (tCa). In 40 cases (29%) pre-operative localization techniques were used. These proved inaccurate in 10 cases. The intra-operative technique of localization with methylene blue infusion was used in 11% of cases. All four glands were biopsied in 11% of cases. No deaths were reported and a postoperative morbidity rate of 3.1% was noted. Eighty-eight per cent of patients were discharged within 5 days of surgery with a third going home within 48 h of neck exploration surgery. Only one patient (0.6%) required re-exploration for persistent hypercalcaemia due to a second adenoma. CONCLUSIONS: The surgical treatment of hyperparathyroidism can be regarded as safe, with minimum morbidity in experienced hands. Pre-operative localization studies in initial parathyroid exploration are not indicated.

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Adolescent Adult Aged Aged, 80 and over Australia Female Humans Hyperparathyroidism Male Medical Audit Middle Aged Parathyroid Glands Postoperative Complications Prospective Studies Journal Article Multicenter Study

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S N Sinha, P Subramaniam. 1996. Initial parathyroid exploration: current trends in Australia.. https://doi.org/10.1111/j.1445-2197.1996.tb01185.x

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