Abstract:
:Recently, the role and timing of surgery for treating secondary and tertiary hyperparathyroidism (HPT) have been questioned. In order to delineate the indications for surgery in these patients, a retrospective analysis of 53 consecutive patients treated with parathyroidectomy was conducted. Subtotal thyroidectomy was done in 37 of 45 patients undergoing their initial operations for HPT. Eight additional patients were referred after failed operations. Of 33 patients with preoperative bone pain, 70% improved. Joint pain improved in 87% of 30 patients, pruritus improved in 81% of 27 patients, and preoperative malaise improved in 73% of 33 patients after parathyroidectomy. Abdominal pain and irritated eyes were unlikely to improve. The best predictors of a successful outcome were a markedly elevated preoperative immunoreactive parathyroid hormone (mid-region) level and an elevated alkaline phosphatase level. There were no perioperative deaths. One patient (1.6%) had a recurrent laryngeal nerve injury, and one patient required reoperation for a neck hematoma. No patient had permanent hypoparathyroidism, but transient hypocalcemia (less than 7 mg/dL) occurred in 22%. Postoperative hypocalcemia correlated with elevated preoperative alkaline phosphatase levels (r2 = 0.247).
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Demeure MJ,McGee DC,Wilkes W,Duh QY,Clark OHdoi
10.1016/s0002-9610(05)80537-9subject
Has Abstractpub_date
1990-10-01 00:00:00pages
337-40issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(05)80537-9journal_volume
160pub_type
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journal_title:American journal of surgery
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更新日期:2014-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2015-11-01 00:00:00
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journal_title:American journal of surgery
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更新日期:2011-04-01 00:00:00
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更新日期:1995-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-12-01 00:00:00
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更新日期:1994-08-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.023
更新日期:2008-12-01 00:00:00
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更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章
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journal_title:American journal of surgery
pub_type: 杂志文章,评审
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更新日期:1994-02-01 00:00:00
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更新日期:1991-03-01 00:00:00
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journal_title:American journal of surgery
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更新日期:1975-06-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Most patients with primary hyperparathyroidism undergo localization prior to operation with variable success. Therefore, in this study we investigated the safety of parathyroidectomy without imaging. METHODS:A prospective database of 2057 surgical patients with primary hyperparathyroidism from 2001 to 2019 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.04.029
更新日期:2020-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2015-06-01 00:00:00
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journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2013.09.026
更新日期:2014-09-01 00:00:00