Endoscopic parathyroidectomy: Report of an initial experience

Miccoli, Paolo; Bendinelli, Cino; Vignali, Edda; Mazzeo, Salvatore; Cecchini, G.; Pinchera, Aldo; Marcocci, Claudio

doi:10.1067/msy.1998.92006

Cited by 150 publications

(95 citation statements)

References 18 publications

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“…Patients with PHPT ask for such a procedure with increased frequency and we have recently shown that it is associated with a shorter operative time, a better cosmetic result, a less painful postoperative course, and a cost (including the intraoperative PTH assay) comparable to that of the standard cervical approach (16,17).…”

Section: Discussionmentioning

confidence: 99%

A quick intraoperative parathyroid hormone assay in the surgical management of patients with primary hyperparathyroidism: a study of 206 consecutive cases

Vignali

Picone

Materazzi

et al. 2002

European Journal of Endocrinology

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Objective: The traditional surgical approach for patients with primary hyperparathyroidism (PHPT) consists of the identification of at least four glands and in the removal of all hyperfunctioning parathyroid tissue. Design: To evaluate whether intraoperative parathyroid hormone (PTH) monitoring will allow a more limited surgical procedure by confirming complete removal of all hyperfunctioning tissue. Methods: Plasma samples were obtained from 206 consecutive patients with sporadic PHPT before skin incision, during manipulation of a suspected adenoma, and 5 min (T-5) and 10 min after removal of abnormal parathyroid tissue. PTH was measured by a quick immunochemiluminescent assay (QPTH). The operative success was defined by a decrease of PTH greater than 50% of the highest pre-excision value. Results: A .50% decrease of PTH occurred in 203 patients and was evident at T-5 in the majority of cases. All but three had normal serum calcium the day after surgery and afterwards. PTH concentration did not show a . 50% decrease in the remaining three cases after completion of surgery. One patients had negative neck exploration and remained hypercalcemic; the other two had normal serum calcium at follow-up. Thus, the intraoperative QPTH correctly predicted the outcome of surgery in 201 patients (97.5%) (200 true positive and 1 true negative), and provided three false positive and two false negative results. Conclusions: The intraoperative QPTH measurement represents a useful tool to assist the surgeon during parathyroidectomy. It indicates whether all hyperfunctioning parathyroid tissue has been removed, limiting the procedure to a unilateral neck exploration in most cases.

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Section: Discussionmentioning

confidence: 99%

A quick intraoperative parathyroid hormone assay in the surgical management of patients with primary hyperparathyroidism: a study of 206 consecutive cases

Vignali

Picone

Materazzi

et al. 2002

European Journal of Endocrinology

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“…The first is an "anterior" approach, which uses a 10-to 15-mm incision just above the sternal notch for the entrance of the camera and endoscopic instruments. The anterior approach permits bilateral exploration if needed and, as described by Miccoli et al [28,29], no gas insufflation is used.…”

Section: Endoscopic Parathyroidectomymentioning

confidence: 99%

Primary Hyperparathyroidism

Suliburk¹,

Perrier

2007

The Oncologist

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LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Discuss the pathophysiology of primary hyperparathyroidism.2. Discuss the clinical presentation, diagnosis, and treatment options for primary hyperparathyroidism.3. Discuss cure of disease and recurrent or persistent disease.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME Disclosure of potential conflicts of interest is found at the end of this article. ABSTRACT

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“…With the wide use of sensitive preoperative localization studies, some veteran general surgeons have advocated the use of a unilateral approach [1][2][3], or even minimally invasive [4], or image-guided parathyroid surgery [5,6], and the potential benefits of these procedures are decreased risks of postoperative hypocalcemia and recurrent nerve injury, and a shorter operating time [7][8][9]. Therefore, can IOPM rule out the patients with multiple adenomas and make the surgery more successful and safer?…”

Section: Discussionmentioning

confidence: 99%

The Safety and Efficacy of Surgery for Primary Hyperparathyroidism without Intraoperative Parathyroid Hormone Measurement in Japan

Uchida¹,

Hibi²,

Kagawa³

et al. 2017

Thyroid Disorders Ther

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Introduction: Primary hyperparathyroidism (PHP) is a curable disease because most patients have only one adenoma and can fully recover after adenoma removal at the location determined by preoperative imaging. However, many Japanese surgeons believe that intraoperative intact PTH measurement (IOPM) is essential to the surgery. Hence, many general surgeons in Japan are unable to perform surgeries for PHP in their local hospitals and must refer the patients to urban high volume centers that have introduced IOPM, even though they are experienced in general surgery and the surgery for PHP is technically simple and related to general surgery. So, we analyzed the relationship of surgical outcomes, with and without IOPM.

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Endoscopic parathyroidectomy: Report of an initial experience

Cited by 150 publications

References 18 publications

A quick intraoperative parathyroid hormone assay in the surgical management of patients with primary hyperparathyroidism: a study of 206 consecutive cases

A quick intraoperative parathyroid hormone assay in the surgical management of patients with primary hyperparathyroidism: a study of 206 consecutive cases

Primary Hyperparathyroidism

The Safety and Efficacy of Surgery for Primary Hyperparathyroidism without Intraoperative Parathyroid Hormone Measurement in Japan

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