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https://www.readbyqxmd.com/read/28108069/predictors-of-operative-failure-in-parathyroidectomy-for-primary-hyperparathyroidism
#1
David C Cron, Steven R Kapeles, Elizabeth A Andraska, Sebastian T Kwon, Peter S Kirk, Brendan L McNeish, Christopher S Lee, David T Hughes
INTRODUCTION: Many adjuncts guide surgical decision making in parathyroidectomy, yet their independent associations with outcome are poorly characterized. We examined a broad range of perioperative factors and used multivariate techniques to identify independent predictors of operative failure (persistent disease) after parathyroidectomy. METHODS: This was a retrospective review of 2239 patients with primary hyperparathyroidism who underwent parathyroidectomy at a single-center from 1999 to 2014...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28104158/incidence-and-risk-factors-of-persistent-hyperparathyroidism-after-kidney-transplantation
#2
K Nakai, H Fujii, T Ishimura, M Fujisawa, S Nishi
Persistent hyperparathyroidism after kidney transplantation is related to graft function, but pre-transplantation risk factors of persistent hyperparathyroidism have not been evaluated in detail. We enrolled 86 patients who had undergone kidney transplantation between 2008 and 2014. Nine patients showed persistent hyperparathyroidism characterized by the following: 1) serum parathyroid hormone levels >65 pg/mL and serum calcium levels >10.5 mg/dL at 1 year after kidney transplantation; 2) parathyroidectomy after kidney transplantation; and 3) reintroduction of cinacalcet after kidney transplantation...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104108/persisting-hypocalcemia-after-surgical-parathyroidectomy-the-differential-effectiveness-of-calcium-citrate-versus-calcium-carbonate-with-acid-suppression
#3
Sabahat Afshan, Abdeen R Farah Musa, Vonda Echols, Anna A Lerant, Tibor Fülöp
The effectiveness of oral calcium (Ca) may be contingent on a patient׳s factors beyond compliance, such as proton-pump inhibitor use and the choice of calcium supplements. A 32-year-old Hispanic male with end-stage renal disease on peritoneal dialysis underwent successful surgical parathyroidectomy (intact parathyroid hormone level: 2,328pg/mL; postsurgical: 287-69pg/mL [normal: 8.5-72.5]). His postoperative course was complicated by severe and recurrent hypocalcemia as outpatient and he needed repeated admissions for intravenous Ca gluconate...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28103657/-a-case-of-primary-hyperparathyroidism-complicated-with-hypercalcemic-crisis-during-treatment-with-cinacalcet-and-improved-by-active-treatment
#4
Tomoki Takeda, Atsushi Okada, Rei Unno, Yukihiro Umemoto, Keiichi Tozawa, Takahiro Yasui
A 77-year-old man was referred to our department for surgical treatment of a right ureteral stone identified on computed tomography (CT) during intensive examination for spondylolisthesis of L4-L5. At the initial visit, performance status was 4, and renal dysfunction was identified (Cr 1.3 mg/dl). Corrected calcium level was 11.8 mg/dl, and intact parathyroid hormone level was 555 pg/ml. A CT scan showed a well-defined mass measuring 22×16×20 mm on the right side of the esophagus, along with 99mTc-MIBI uptake in the lesion...
December 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28091771/localization-of-parathyroid-adenomas-using-11-c-methionine-pet-after-prior-inconclusive-imaging
#5
Milou E Noltes, Annemieke M Coester, Anouk N A van der Horst-Schrivers, Bart Dorgelo, Liesbeth Jansen, Walter Noordzij, Clara Lemstra, Adrienne H Brouwers, Schelto Kruijff
PURPOSE: Minimally invasive parathyroidectomy (MIP) is the recommended treatment in primary hyperparathyroidism (pHPT) for which accurate preoperative localization is essential. The current imaging standard consists of cervical ultrasonography (cUS) and MIBI-SPECT/CT. (11)C-MET PET/CT has a higher resolution than MIBI-SPECT/CT. The aim of this study was to determine the diagnostic performance of (11)C-MET PET/CT after initial inconclusive or negative localization. METHODS: We performed a retrospective single center cohort study of patients with pHPT undergoing parathyroid surgery after prior negative imaging and later localization by means of (11)C-MET PET/CT between 2006 and 2014...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28078796/hyperparathyroidism-caused-by-distant-pulmonary-lesions-and-parathyromatosis-after-ethanol-injection-parathyroidectomy-for-secondary-hyperparathyroidism
#6
Michio Nakamura, Kiho Tanaka, Takeshi Fujii
Secondary hyperparathyroidism (SHPT) treatment includes parathyroidectomy and percutaneous ethanol injection therapy (PEIT), which are invasive procedures. The condition in which benign hyperfunctioning parathyroid tissue is distributed throughout the neck and mediastinum is termed parathyromatosis. Here, we present the case of a 51-year-old woman who began hemodialysis in 1986 due to chronic kidney disease of unknown etiology and developed SHPT in 1999. She underwent 6 rounds of PEIT followed by total a parathyroidectomy with partial forearm autotransplantation...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28073343/risk-factors-and-clinical-course-of-hungry-bone-syndrome-after-total-parathyroidectomy-in-dialysis-patients-with-secondary-hyperparathyroidism
#7
Lo-Yi Ho, Ping-Nam Wong, Ho-Kwan Sin, Yuk-Yi Wong, Kwok-Chi Lo, Shuk-Fan Chan, Man-Wai Lo, Kin-Yee Lo, Siu-Ka Mak, Andrew Kui-Man Wong
BACKGROUND: Hungry bone syndrome (HBS) is an important postoperative complication after parathyroidectomy for severe secondary hyperparathyroidism (SHPT). There is, however, little data in the literature on its detailed clinical course, and the associated risk factors remain controversial. METHODS: We did a single-center retrospective study on 62 consecutive dialysis patients who underwent total parathyroidectomy for SHPT to examine the risk factors, clinical course and outcome...
January 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28054194/ultrasound-based-scores-as-predictors-for-nodular-hyperplasia-in-patients-with-secondary-hyperparathyroidism-a-prospective-validation-study
#8
Jill Gwiasda, Alexander Kaltenborn, Jörg A Müller, Michaela Serttas, Georg W F Scheumann, Harald Schrem, Mark D Jäger
PURPOSE: Former studies evaluated echostructural and vascular patterns in ultrasound of the parathyroid gland to identify nodular hyperplasia in patients with secondary hyperparathyroidism due to chronic kidney disease. This prospective study aims to externally validate suggested ultrasound classifications. METHODS: Parathyroid glands of 27 patients with secondary hyperparathyroidism undergoing parathyroidectomy were prospectively analyzed. Ultrasound including Doppler imaging was performed 1 day prior to surgery...
January 4, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28044233/management-of-secondary-hyperparathyroidism-how-and-why
#9
REVIEW
Hirotaka Komaba, Takatoshi Kakuta, Masafumi Fukagawa
Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease. Currently, various treatment options are available, including vitamin D receptor activators, cinacalcet hydrochloride, and parathyroidectomy. These treatment options have contributed to the successful control of SHPT, and recent clinical studies have provided evidence suggesting that effective treatment of SHPT leads to improved survival. Although bone disease is the most widely recognized consequence of SHPT and remains a major target for treatment of SHPT, there is increasing evidence that parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), both of which are markedly elevated in SHPT, have multiple adverse effects on extraskeletal tissues...
January 2, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28034706/vagal-and-recurrent-laryngeal-nerves-neuromonitoring-during-thyroidectomy-and-parathyroidectomy-a-prospective-study
#10
N Julien, E Ferrary, A Sokoloff, G Lamas, O Sterkers, D Bernadeschi
OBJECTIVES: The aim of the study was to stimulate the vagal and the recurrent laryngeal nerves during and after thyroidectomy or parathyroidectomy, to record muscle responses, interpret the electrophysiological modifications and identify prognostic factors for postoperative vocal fold mobility. PATIENTS AND METHODS: A prospective study monitored 151 vagal nerves and 144 recurrent laryngeal nerves in 114 patients. Seven patients (14 vagal nerves) underwent continuous monitoring via an automatic periodic stimulation (APS(®)) electrode...
December 26, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28032553/using-parathyroid-hormone-spikes-during-parathyroidectomy-to-guide-intraoperative-decision-making
#11
Azadeh A Carr, Tina W Yen, Stuart D Wilson, Douglas B Evans, Tracy S Wang
BACKGROUND: Intraoperative parathyroid hormone (IOPTH) level monitoring is a useful adjunct to parathyroidectomy for primary hyperparathyroidism (pHPT). Occasionally, increases ("spikes") in IOPTH levels from the preoperative baseline parathyroid hormone may occur, which may lead to longer operative times or more extensive neck exploration or both. The aim of this study was to determine if the extent of IOPTH level increase predicts single gland disease (SGD). METHODS: This is a retrospective review of a prospective parathyroid database of patients undergoing parathyroidectomy for sporadic pHPT from 1999-2013...
October 14, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28032220/transoral-endoscopic-parathyroidectomy-vestibular-approach-a-novel-scarless-parathyroid-surgery
#12
Thanyawat Sasanakietkul, Pornpeera Jitpratoom, Angkoon Anuwong
BACKGROUND: Natural orifice transluminal endoscopic surgery developed for neck surgery become increasing popular. Herein, an innovative transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) was developed for primary hyperparathyroidism (PHPT) and renal hyperparathyroidism (rHPT). METHODS: Incisions were made at the oral vestibule under the inferior lip. A 10-mm trocar was inserted through the center of the oral vestibule with two 5-mm trocars laterally...
December 28, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28017299/is-intraoperative-parathyroid-hormone-monitoring-necessary-for-primary-hyperparathyroidism-with-concordant-preoperative-imaging
#13
Iuliana D Bobanga, Christopher R McHenry
BACKGROUND: The purpose of this study was to determine if intraoperative parathyroid hormone (PTH) monitoring is necessary in patients with concordant ultrasound and sestamibi imaging. METHODS: Clinical factors, intraoperative findings and outcome were correlated with imaging results in patients with primary hyperparathyroidism who underwent parathyroidectomy with concordant ultrasound and sestamibi imaging. RESULTS: There were 127 patients with primary hyperparathyroidism and concordant imaging who underwent parathyroidectomy...
November 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28003944/role-of-intraoperative-nerve-monitoring-during-parathyroidectomy-to-prevent-recurrent-laryngeal-nerve-injury
#14
REVIEW
Usman Ghani, Salman Assad, Shuja Assad
Injury to the recurrent laryngeal nerve (RLN) is a well known, though less frequent, complication of parathyroid surgery. In recent years, the use of intraoperative nerve monitoring (IONM) has gained popularity amongst surgeons when operating on thyroid gland; however, its utilization in parathyroid surgery is not established. This trend continues to rise, despite multiple studies documenting no statistically significant difference that IONM decreases the incidence of RLN injury. Most surgeons use this technology as an adjunct to visualization alone for identification of RLN...
November 15, 2016: Curēus
https://www.readbyqxmd.com/read/27999806/changes-in-serum-concentrations-of-fibroblast-growth-factor-23-and-soluble-klotho-in-hemodialysis-patients-after-total-parathyroidectomy
#15
Shang-Chih Liao, Sin-Hua Moi, Fong-Fu Chou, Cheng-Hong Yang, Jin-Bor Chen
Background. We examined the changes in circulating fibroblast growth factor 23 (FGF23) and Klotho concentrations in hemodialysis patients after parathyroidectomy (PTX). Methods. We enrolled a cohort of hemodialysis patients who received PTX. Postoperatively, patients received calcium supplements and/or vitamin D analogue (calcitriol) to maintain serum calcium within 7.0-8.0 mg/dL. Information on clinical parameters including bone-mineral metabolic variables was collected pre-PTX and on days 5 and 90 after PTX...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27991480/mineral-bone-disorder-and-its-management-among-hemodialysis-patients-in-the-gulf-cooperation-council-initial-findings-from-the-dialysis-outcomes-and-practice-patterns-study-2012-2015
#16
Issa Al Salmi, Mona AlRukhaimi, Ali AlSahow, Faisal A M Shaheen, Saeed M G Al-Ghamdi, Fadwa AlAli, Sumaya AlGhareeb, Yacoub Al Maimani, Mohammed AlGhonaim, Brian Bieber, Francesca Tentori, Ronald L Pisoni
The prospective cohort Dialysis Outcomes and Practice Patterns Study (DOPPS) initiated data collection in national samples of hemodialysis (HD) units (total of 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in late 2012. Here, we report initial results regarding mineral bone disorders (MBDs) and its management in the GCC countries. Forty-one randomly selected HD facilities, treating >23 HD patients each, were sampled and represent care for >95% of GCC HD patients...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27989915/application-of-carbon-nanoparticles-accelerates-the-rapid-recovery-of-parathyroid-function-during-thyroid-carcinoma-surgery-with-central-lymph-node-dissection-a-retrospective-cohort-study
#17
Bin Wang, Zhi-Peng Du, Nian-Cun Qiu, Miao-E Liu, Sheng Liu, Dao-Zhen Jiang, Wei Zhang, Ming Qiu
BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the efficacy of carbon nanoparticles in identifying lymph nodes and promoting parathyroid gland function recovery after thyroid carcinoma surgery along with central lymph node dissection. METHODS: A total of 231 patients who underwent thyroid carcinoma surgery combined with central lymph node dissection were divided into two groups: the CN group (intraoperative carbon nanoparticles injections) and the control group (no injection)...
October 27, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27989606/improving-diagnostic-recognition-of-primary-hyperparathyroidism-with-machine-learning
#18
Yash R Somnay, Mark Craven, Kelly L McCoy, Sally E Carty, Tracy S Wang, Caprice C Greenberg, David F Schneider
BACKGROUND: Parathyroidectomy offers the only cure for primary hyperparathyroidism, but today only 50% of primary hyperparathyroidism patients are referred for operation, in large part, because the condition is widely under-recognized. The diagnosis of primary hyperparathyroidism can be especially challenging with mild biochemical indices. Machine learning is a collection of methods in which computers build predictive algorithms based on labeled examples. With the aim of facilitating diagnosis, we tested the ability of machine learning to distinguish primary hyperparathyroidism from normal physiology using clinical and laboratory data...
December 15, 2016: Surgery
https://www.readbyqxmd.com/read/27982325/the-deceptive-concept-of-hypoparathyroidism-and-recurrence-after-parathyroidectomy-in-dialysis-patients-are-we-offering-a-procrustean-bed-to-some-patients
#19
Fabio Luiz DE Menezes Montenegro, Marilia D'Elboux Guimaraes Brescia, Climério Pereira Nascimento, Ledo Mazzei Massoni, Sérgio Samir Arap, Stênio Roberto Castro Lima Santos, Patrícia Taschner Goldenstein, Rodrigo Oliveira Bueno, Melani Ribeiro Custodio, Vanda Jorgetti, Rosa Maria Affonso Moyses
Objective: to analyze the frequency of hypoparathyroidism and of its recurrence after parathyroidectomy in dialysis patients according to different existing classifications. Methods: we conducted a retrospective study of 107 consecutive dialysis patients undergoing total parathyroidectomy with immediate autograft in a tertiary hospital from 2006 to 2010. We studied the changes in PTH levels in the postoperative period over time. Were grouped patients according to different PTH levels targets recommended according to the dosage method and by the American and Japanese Nephrology Societies, and by an International Experts Consortium...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27979480/location-of-abnormal-parathyroid-glands-lessons-from-810-parathyroidectomies
#20
Melissa LoPinto, Gustavo A Rubio, Zahra F Khan, Tanaz M Vaghaiwalla, Josefina C Farra, John I Lew
BACKGROUND: Primary hyperparathyroidism (pHPT) is commonly treated with targeted parathyroidectomy (PTX) guided by preoperative imaging and intraoperative parathormone monitoring. Despite advanced imaging techniques, failure of parathyroid localization still occurs. This study determines the anatomical distribution of single abnormal parathyroid glands, which may help direct the surgeon in PTX when preoperative localization is unsuccessful. METHODS: A retrospective review of prospectively collected data of 810 patients with pHPT who underwent initial PTX at a tertiary medical center was performed...
January 2017: Journal of Surgical Research
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