Maximizing Outcomes While Minimizing Exploration in Hyperparathyroidism Using Localization Tests

Publisher Website
Google Scholar
Abstract
Hypothesis Preoperative localization (ultrasonography and scintigraphy) can be used to limit operative exploration in primary hyperparathyroidism while providing a high rate of success. Design Prospective cohort analysis of 3 types of exploration (1-gland, unilateral, or 4-gland), as directed by localization. Results In 185 consecutive patients who underwent operations, the final diagnoses were solitary adenoma in 87% and multigland disease in 13%. Ultrasonography (75%) and scintigraphy (83%) demonstrated an enlarged parathyroid gland and, together with operative findings, resulted in 61 1-gland, 63 unilateral, and 61 4-gland explorations, with an initial success rate of 96% and an ultimate success rate of 99%. Limiting exploration resulted in a significant decrease in operative time and hospitalization. Conclusion Localization can limit exploration with success.