ArticleUpdates in surgery2016
Feasibility of unilateral parathyroidectomy in patients with primary hyperparathyroidism and negative or discordant localization studies.
Article in Updates in surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 20 citations in OpenAlex.
- Correlation between parathyroid adenoma volume and perioperative outcomes in primary hyperparathyroidism: Does the size matter?Updates in surgery · 2025Article
- Intraoperative Parathyroid Hormone Monitoring Criteria in Primary Hyperparathyroidism: A Network Meta-Analysis of Diagnostic Test Accuracy.JAMA otolaryngology-- head & neck surgery · 2025Article
- A mini-invasive approach is feasible in patients with primary hyperparathyroidism and discordant or negative localisation studies.Updates in surgery · 2022Article
- Selective venous sampling in primary hyperparathyroidism: Is it worth doing?Turkish journal of medical sciences · 2022Article
- The Role of Bilateral Neck Exploration for Primary Hyperparathyroidism in the Minimally Invasive Parathyroidectomy Era.Sisli Etfal Hastanesi tip bulteni · 2022Article
- Selection of parathyroidectomy methods for primary hyperparathyroidism according to concordance between ultrasonography and MIBI scan results.Gland surgery · 2021Article
- Actual role of color-doppler high-resolution neck ultrasonography in primary hyperparathyroidism: a clinical review and an observational study with a comparison ofJournal of ultrasound · 2019Observational
- Intraoperative parathyroid hormone (PTH) testing in patients with primary hyperparathyroidism and PTH levels in the normal range.BMC surgery · 2019Article
- Focused parathyroidectomy for single parathyroid adenoma: a clinical account of 20 patients.Electronic physician · 2018Article
- Risk factors for postoperative hypocalcemia.Updates in surgery · 2017Article
- The diagnostic and therapeutic challenges in the management of a double giant parathyroid adenoma.Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, IndiaArticle
- Advantages of theIndian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, IndiaArticle
- Radio-guided Minimally Invasive Parathyroidectomy: A Descriptive Report of the Experience from Tertiary Center in Bangalore.Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, IndiaArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of this study was to examine the feasibility of unilateral parathyroidectomy in patients with primary hyperparathyroidism and negative or discordant localization studies. We included in our study 72 patients with preoperative diagnosis of primary hyperparathyroidism who had negative or discordant preoperative studies. In 66 patients, studies were discordant while in six were both negative. In 40 (55.6 %) patients initial approach was a bilateral exploration. In 32 cases (44.4 %) initial surgery was a unilateral exploration: in 26 conservative approach was successful, in six mini-invasive surgery failed and a bilateral exploration was necessary due to IOPTH negative test (five cases) or to the impossibility to find a pathological gland during exploration (one case). Intra-operative PTH test showed a sensitivity of 93.2 %, a specificity of 92.3 %, and an accuracy of 93.1 %. Multiple gland disease was found in 8 (11.1 %) patients (two double adenoma and six multiple gland hyperplasia). Mean operative time was lower in unilateral exploration group (87.9 ± 43.8 min). Comparing unilateral surgery in negative or discordant studies with 77 consecutive patients who underwent focused surgery with positive and concordant studies, conversion to bilateral exploration rate was statistically significantly higher in the first group (15.6 %). We believe that unilateral parathyroidectomy can be safely performed also in patients with discordant localization studies with a high cure rate; in these cases, however, the use of intra-operative PTH is absolutely necessary. We suggest the need for referral of these patients to high-volume medical centers for thyroid and parathyroid surgery.
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