Surgical Management of Primary Hyperparathyroidism—Clinicopathologic Study of 1019 Cases from a Single Institution

Gawrychowski, Jacek; Kowalski, Grzegorz; Buła, Grzegorz; Bednarczyk, Adam; Żądło, Dominika; Niedzielski, Zbigniew; Gawrychowska, Agata; Koziołek, Henryk

doi:10.3390/jcm9113540

Cited by 7 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found this finding to be interesting, because one might consider that increased parathyroid tissue activity, to which a more intense uptake might correspond, does not appear to be related to PTH kinetics. It also appears clear that the higher persistence rate with ectopic pathological parathyroid localizations (intrathyroid, mediastinal) refers to sporadic cases with a higher failure rate, which is consistent with literature data 34 – 36 .…”

Section: Discussionsupporting

confidence: 89%

Interpretation of intraoperative parathyroid hormone monitoring according to the Rome criterion in primary hyperparathyroidism

Graceffa

Cipolla

Calagna

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Intraoperative parathyroid hormone dosage allows real-time monitoring of the decrease in PTH levels during parathyroidectomy and verify procedure’s efficacy. Currently, none of the interpretative criteria used has absolute accuracy. The aim of this study is to evaluate diagnostic accuracy of the Rome criterion verifying diagnostic significance of the individual assays. A total of 205 patients with primary hyperparathyroidism from a single adenoma were retrospectively evaluated and monitored with baseline PTH, PTH at 10 min and PTH at 20 min after adenoma excision. The accuracy of the latter two assays compared with baseline was compared by ROC curves. In addition, was evaluated the influence on these data of localization diagnostics (ultrasounds and scintigraphy), definitive histology, and type of surgery performed. The ratio of 20-min sampling to baseline in the Rome criterion showed highest diagnostic significance. This finding was not influenced by the type of surgery performed, definitive histologic examination, or intraoperative localization of the adenoma. The Rome criterion has shown its high reliability in detecting persistence. The ratio of sampling at 20 min to baseline is by far the best performing. Further studies are needed to evaluate whether sampling at 10 min after adenoma excision can be considered not mandatory.

show abstract

Section: Discussionsupporting

confidence: 89%

Interpretation of intraoperative parathyroid hormone monitoring according to the Rome criterion in primary hyperparathyroidism

Graceffa

Cipolla

Calagna

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Usually, the first line test is sestamibi technetium-99m scintigraphy (MIBI), and later, well-performed USG can be a confirmatory method [ 13 , 14 ]. Moreover, the use of the single-photon emission computed tomography (SPECT) technique and 4D-CT provides the high possibility of anatomic detail and affords the high likelihood of achieving a safe and successful operation [ 15 , 16 ]. MRI are useful in the detection of particularly ectopic extra parathyroid mediastinal lesions [ 5 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Multiglandular Parathyroid Disease

Kowalski¹,

Buła²,

Bednarczyk³

et al. 2022

Life

Self Cite

View full text Add to dashboard Cite

Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures. Methods: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with a group of 856 patients with solitary disease operated for pHPT in the same period. Results: Among 163 patients—127 (79%) of them had two lesions, 28 (16%) had three, and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) as well for us. Treatment was surgical. Conclusions: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Diagnosis is based on PTH and calcium levels. Ultrasonography (USG), MRI, and scintigraphy are very helpful in diagnosis. Mediastinal multiglandular parathyroid disease (MGD) is associated with increased surgical treatment failures. The treatment is surgical and consists of the removal of the masses or complete parathyroidectomy. Based on this study, we support the existence of multiple adenomas and advocate the removal of only macroscopically enlarged parathyroid glands in patients with primary hyperparathyroidism.

show abstract

“…Interesting findings were also presented by Gawrychowski et al in a study concerning surgical management of PHP [24]. This was a retrospective clinicopathologic analysis on 1019 patients from a single institution treated throughout a period of 35 years.…”

mentioning

confidence: 77%

Editorial on the Special Issue “Novel Methods of Diagnostics of Thyroid and Parathyroid Lesions”

Szczepanek‐Parulska

Ruchała

2022

JCM

View full text Add to dashboard Cite

show abstract

Surgical Management of Primary Hyperparathyroidism—Clinicopathologic Study of 1019 Cases from a Single Institution

Cited by 7 publications

References 32 publications

Interpretation of intraoperative parathyroid hormone monitoring according to the Rome criterion in primary hyperparathyroidism

Interpretation of intraoperative parathyroid hormone monitoring according to the Rome criterion in primary hyperparathyroidism

Multiglandular Parathyroid Disease

Editorial on the Special Issue “Novel Methods of Diagnostics of Thyroid and Parathyroid Lesions”

Contact Info

Product

Resources

About