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Department of Clinical Physiology and Nuclear Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
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bone resorption. Moreover, increased PTH indirectly results in increased intestinal Ca 2+ absorption promoted by an increased renal activation of vitamin D ( 1 , 2 , 3 ). The only curative treatment is parathyroidectomy (PTx), that is the surgical
Parathyroid Unit – LIM-28, Laboratório de Cirurgia de Cabeça e Pescoço, Division of Head and Neck Surgery, Department of Surgery, Hospital das Clinicas (HCFMUSP), University of São Paulo School of Medicine (FMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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Endocrine Oncology Division, Institute of Cancer of the State of São Paulo (ICESP), University of São Paulo School of Medicine (FMUSP), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, São Paulo, Brazil
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Endocrine Oncology Division, Institute of Cancer of the State of São Paulo (ICESP), University of São Paulo School of Medicine (FMUSP), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, São Paulo, Brazil
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by periodic hormonal and radiologic screening ( 1 , 6 , 8 , 9 , 10 , 11 ). Therefore, young patients are predominantly asymptomatic at the time of pHPT diagnosis ( 1 , 2 , 6 , 9 , 11 ). Although parathyroidectomy (PTx) is the consensual
Division of General and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau AG, Aarau, Switzerland
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University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland
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Division of General and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau AG, Aarau, Switzerland
Faculty of Medicine, University Hospital Basel, Basel, Switzerland
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Division of General and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau AG, Aarau, Switzerland
Faculty of Medicine, University Hospital Basel, Basel, Switzerland
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sex and race ( 2 , 3 , 4 , 5 ). Parathyroidectomy (PTX) is the only known curative treatment for pHPT. Previous studies found a steady rise in PTXs performed during the past decades ( 5 , 6 ), while a study from the US still reported
College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, China Medical University Hospital, Taichung, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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for parathyroidectomy ( 5 ). Surgical methods employed in SHPT are total parathyroidectomy, subtotal parathyroidectomy, and total parathyroidectomy with autotransplantation. Among them, total parathyroidectomy has fallen out of favor because of the
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about this specific type of PHPT have been published in recent years. Total parathyroidectomy (TPTX) with autotransplantation of parathyroid tissue in a forearm muscle or subtotal parathyroidectomy (SPTX) is the treatment of choice. A simultaneous
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First Pavlov State Medical University, St. Petersburg, Russia
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First Pavlov State Medical University, St. Petersburg, Russia
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patients underwent parathyroidectomy. The vast majority had removal of a single adenoma (360 patients; 93.0%). Multiple adenomas were identified in 20 (5.2%) cases and only seven patients (1.8%) had hyperplasia of parathyroid glands. Seven patients did not
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Faculty of Medicine, University of Oslo, Oslo, Norway
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Faculty of Medicine, University of Oslo, Oslo, Norway
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disease. Treatment in overt PHPT is parathyroidectomy while the optimal management of mild or asymptomatic PHPT has been discussed for a long time. Observational studies have demonstrated an association of increased calcium levels and PHPT to
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Department of Medical Genetics, Cambridge University, Cambridge, UK
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.0023 ) 9 Koman A Ohlsson S Bränström R Pernow Y Bränström R Nilsson IL . Short-term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy . British Journal of Surgery 2019 106
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, improper use of electrocauterization or destruction due to hematoma formation ( 9 , 10 ). Meticulous dissection is a preferred method to preserve parathyroid glands with their blood supply in situ and to prevent inadvertent parathyroidectomy. However
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total score is below 3. A 2015 study retrospectively analyzed 1421 patients with PHPT who underwent parathyroidectomy at the University of Wisconsin Hospital between 2003 and 2012 and showed that the PPV of a CaPTHUS score of ≥3 predicting SGD decreased