09 September 2014 : Original article
Reoperations for Persistent or Recurrent Primary Hyperparathyroidism: Results of a Retrospective Cohort Study at a Tertiary Referral CenterIreneusz NawrotADEFG, Witold ChudzińskiABDF, Tomasz CiąćkaBF, Marcin BarczyńskiACDE, Jacek SzmidtAD
Med Sci Monit 2014; 20:1604-1612
BACKGROUND: Parathyroid reoperations are challenging and achieving a cure requires multidisciplinary treatment team cooperation. The aims of this study were to summarize our experience in revision surgery for persistent (pHPT) or recurrent primary hyperparathyroidism (rHPT) and to explore factors underlying failure to cure at initial surgery.
MATERIAL AND METHODS: This was a retrospective cohort study of patients who underwent reoperations for pHPT or rHPT at a tertiary referral center. The database of parathyroid surgery was searched for eligible patients (treated in the years 2000–2012). The primary outcome was the cure rate. All the patients were followed-up for at least 12 months postoperatively. Factors underlying failure to cure at initial surgery were reviewed based on hospital records.
RESULTS: The study group comprised 88 patients (69 women, 19 men) operated on for persistent (n=57) or recurrent disease (n=31), who underwent 98 reoperations, including 26 (2.4%) patients first operated on at our institution, and 72 (81.8%) patients operated on elsewhere, but referred for revision surgery. A long-term cure was achieved in 83/88 patients (94.3%). The mean post-reoperation follow-up was 91.7 (12–176) months. Missed hyperfunctioning parathyroid gland was found on reoperation in eutopic position in 49 (55.5%) patients, and in ectopic position in 39 (44.3%) patients, including 20 (22.7%) cases of cervical ectopy and 19 (21.6%) cases of mediastinal ectopy.
CONCLUSIONS: Multidisciplinary treatment team cooperation at a tertiary referral center, consisting of an accurate preoperative localization, expertise in parathyroid re-explorations, and correct use of intraoperative adjuncts, contribute to the high success rate of parathyroid reoperations.
Keywords: Adolescent, Aged, 80 and over, Hyperparathyroidism, Primary - surgery, Preoperative Care, Recurrence, Reoperation, Tertiary Care Centers, young adult
01 December 2021 : EditorialEditorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19
Med Sci Monit 2021; 27:e935624
03 December 2021 : Laboratory ResearchInfluenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Season a...
Med Sci Monit In Press; DOI: 10.12659/MSM.934862
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
01 November 2021 : EditorialEditorial: What Can be Learned from National and International Vaccine Adverse Event Reporting Systems Duri...
Med Sci Monit 2022; 28:e935299
07 Dec 2021 : Review articleA Review of the Impact of Neutrophils and Neutrophil Extracellular Traps (NETs) on the Development of Aorti...
Med Sci Monit In Press; DOI: 10.12659/MSM.935134
07 Dec 2021 : Review articleAdie’s Pupil: A Diagnostic Challenge for the Physician
Med Sci Monit In Press; DOI: 10.12659/MSM.934657
06 Dec 2021 : Animal ResearchAstragalus Flavone Induces Proliferation and Differentiation of Neural Stem Cells in a Cerebral Infarction ...
Med Sci Monit In Press; DOI: 10.12659/MSM.933830
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700