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Langenbeck's Archives of Surgery

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01.09.2009 | Current Concepts in Endocrine Surgery

Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations

verfasst von: Radu Mihai, Marcin Barczynski, Maurizio Iacobone, Antonio Sitges-Serra

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 5/2009

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Abstract

Purpose

Progress in parathyroid imaging has brought substantial changes in the surgical strategy to approach patients with sporadic primary hyperparathyroidism (pHPT). The present review is focused on the safety and efficacy of limited parathyroid exploration.

Materials and methods

Review of the literature focused on studies dealing with unilateral (two-gland exploration) or selective parathyroidectomy (one-gland exploration) in selected patients with pHPT and on the classification of published reports according to the degree of evidence.

Results

Parathyroid exploration limited to a solitary parathyroid adenoma can be considered a minimally invasive procedure that can be performed by the minicervicotomy, video-assisted, or endoscopic approaches. In properly selected patients, it affords results comparable to those of four-gland bilateral exploration in terms of cure and recurrence. It causes less postoperative hypocalcemia.

Conclusions

Selective parathyroidectomy is an option for patients with positive preoperative localization tests undergoing first-time surgery who have no family history of pHPT, no goiter for which surgical therapy is proposed, and are not on lithium therapy.

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Titel: Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations
verfasst von: Radu Mihai
Marcin Barczynski
Maurizio Iacobone
Antonio Sitges-Serra
Publikationsdatum: 01.09.2009
Verlag: Springer-Verlag
Erschienen in: Langenbeck's Archives of Surgery / Ausgabe 5/2009
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-009-0529-1

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Surgical strategy for sporadic primary hyperparathyroidism an evidence-based approach to surgical strategy, patient selection, surgical access, and reoperations

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S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“