Primary hyperparathyroidism

Current Opinion in Oncology

Volumn 16, Issue 1, 2004, Pages 1-7

  Åkerström, Göran ^a   Hellman, Per ^a  

^a UPPSALA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Genetics; Histopathology; Medical treatment; Parathyroid gland; Primary hyperparathyroidism; Surgery

Indexed keywords

BISPHOSPHONIC ACID DERIVATIVE; CALCIMIMETIC AGENT; VITAMIN D; VITAMIN D DERIVATIVE;

BONE DISEASE; BONE MINERAL; BONE TURNOVER; CANCER GENETICS; CANCER SURGERY; CARDIOVASCULAR DISEASE; DIAGNOSTIC PROCEDURE; DISABILITY; ECHOGRAPHY; ENDOCRINE TUMOR; GENETIC ANALYSIS; GENETIC ASSOCIATION; HEALTH CARE COST; HETEROZYGOSITY; HISTOPATHOLOGY; HOSPITALIZATION; HUMAN; IMAGING SYSTEM; KIDNEY DISEASE; LENGTH OF STAY; MEDICAL RESEARCH; MENTAL DISEASE; MINIMALLY INVASIVE SURGERY; NEPHROLITHIASIS; OSTEOLYSIS; OSTEOPOROSIS; PARATHYROID TUMOR; PARATHYROIDECTOMY; PRIMARY HYPERPARATHYROIDISM; PRIORITY JOURNAL; REVIEW; RISK ASSESSMENT; SURGICAL APPROACH; SURGICAL PATIENT; SURGICAL TECHNIQUE; SYMPTOM; TREATMENT INDICATION; TUMOR LOCALIZATION; ADULT; AGE; AGED; BONE DENSITY; FEMALE; HYPERPARATHYROIDISM; MALE; MIDDLE AGED; PARATHYROID GLAND; PATHOLOGY; POSTMENOPAUSE; PROGNOSIS;

ADULT; AGE FACTORS; AGED; BONE DENSITY; FEMALE; HUMANS; HYPERPARATHYROIDISM; LENGTH OF STAY; MALE; MIDDLE AGED; PARATHYROID GLANDS; POSTMENOPAUSE; PROGNOSIS; VITAMIN D;

EID: 2442492279     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001622-200401000-00002     Document Type: Review

References (88)

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83. Schell SR, Dudley NE: Clinical outcomes and fiscal consequences of bilateral neck exploration for primary idiopathic hyperparathyroidism without preoperative radionuclide imaging or minimally invasive techniques. Surgery 2003, 133:32-39. Altogether, 688 patients with pHPT were subjected to conventional bilateral neck exploration, without pre- or intraoperative guidance. Single adenoma was found in 78.8% of patients, multiglandular disease in 14.2% (of which 3.2% had multiple adenomas), and parathyroid carcinoma in 1.5%. The cure rate assessed by serum calcium and PTH levels after 3 and 12 months of follow-up was 97.7%. Mean operating time for the entire series was 65 minutes, and decreased to 35 minutes when patients with adenomas were selected. The authors calculated that the total cost for a patient undergoing exploration for single adenoma was one third less than the cost of a scan-directed minimally invasive operation.
84. Kebebew E, Duh QY, Clark OH: Parathyroidectomy for primary hyperparathyroidism in octogenarians and nonagenarians: a plea for early surgical referral. Arch Surg 2003, 138:867-871. Conventional parathyroidectomy in patients older than 80 years was found to be safe, curative, and beneficial.
85. Hedback G, Oden A: Recurrence of hyperparathyroidism; a long-term followup after surgery for primary hyperparathyroidism. Eur J Endocrinol 2003, 148:413-421. Recurrent hypercalcemia occurred after conventional neck exploration for HPT in 4.5% of patients and could be encountered more than 20 years after treatment in both single and multiple gland disease.
86. Parker C, Blackwell P, Fairbairn K, et al.: Alendronate in the treatment of primary hyperparathyroid-related osteoporosis: a 2-year study. J Clin Endocrinol Metab 2002, 87:4482-4489. Alendronate is well tolerated and improves bone mineral density in the lumbar spine, especially within the first year of treatment. Short-term changes in calcium and PTH resolve by 3 months.
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88. Carty SE, Roberts MM, Virji MA, et al.: Elevated parathyroid hormone level after "concise parathyroidectomy" for sporadic primary hyperparahyroidism. Surgery 2002, 132:1086-1092. Compensatory normocalcemic elevation of PTH is frequent after successful parathyroid surgery and may arise from deficiency of calcium and vitamin D. Follow-up is needed to exclude residual disease.