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Parathyroidectomy

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https://www.readbyqxmd.com/read/29331397/persistent-hyperparathyroidism-as-a-risk-factor-for-long-term-graft-failure-the-need-to-discuss-indication-for-parathyroidectomy
#1
Maria Júlia Correia Lima Nepomuceno Araujo, Janaina Almeida Mota Ramalho, Rosilene Motta Elias, Vanda Jorgetti, William Nahas, Melani Custodio, Rosa M A Moysés, Elias David-Neto
BACKGROUND: Although a successful kidney transplant (KTx) improves most of the mineral and bone disorders (MBD) produced by chronic kidney disease (CKD), hyperparathyroidism may persist (pHPT). Current guidelines recommend parathyroidectomy if serum parathormone is persistently elevated 1 year after KTx, because pHPT has been recently associated with poor graft outcomes. However, whether patients with pHPT and adequate renal function are at risk for long-term graft failure is unknown...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29322019/to-identify-or-not-to-identify-parathyroid-glands-during-total-thyroidectomy
#2
REVIEW
Yuk Kwan Chang, Brian H H Lang
Hypoparathyroidism is one of the most common complications after total thyroidectomy and may impose a significant burden to both the patient and clinician. The extent of thyroid resection, surgical techniques, concomitant central neck dissection, parathyroid gland (PG) autotransplantation and inadvertent parathyroidectomy have long been some of the risk factors for postoperative hypoparathyroidism. Although routine identification of PGs has traditionally been advocated by surgeons, recent evidence has suggested that perhaps identifying fewer number of in situ PGs during surgery (i...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29310821/sestamibi-spect-ct-versus-spect-only-for-preoperative-localization-in-primary-hyperparathyroidism-a-single-institution-8-year-analysis
#3
Kelly L McCoy, Anish G Ghodadra, Trilochan G Hiremath, Angela Albarano, Judith M Joyce, Linwah Yip, Sally E Carty, Ashok Muthukrishnan
BACKGROUND: Primary hyperparathyroidism is caused by single gland disease in 85% of cases and by multiglandular disease in 15%. Our aim was to discover if the addition of computed tomography acquisition/fusion on a hybrid scanner to traditional dual-phase single-photon emission tomography improves localization accuracy. METHODS: A prospective database was queried for the perioperative data of patients with sporadic primary hyperparathyroidism who had initial exploration from 2006-2014 with ≥6 month follow-up to define anatomy...
January 5, 2018: Surgery
https://www.readbyqxmd.com/read/29306227/parathyroid-hormone-in-washout-fluid-seems-to-be-superior-to-cytology-for-localization-of-the-lesion-in-mibi-negative-patients-with-primary-hyperparathyroidism
#4
Güven Barış Cansu, Bengür Taşkıran, Hayrettin Dizen, Betül Peker Cengiz
Background/aim: Primary hyperparathyroidism (PHPT) is characterized by increased calcium (Ca) and parathyroid hormone (PTH) levels. Surgical removal of the culprit hyperfunctioning parathyroid gland is the preferred treatment. In this study, we aimed to determine whether PTH-washout or cytological examination of suspicious lesions was superior in MIBI-negative patients diagnosed with PHPT.Materials and methods: We retrospectively evaluated the medical records of 98 patients diagnosed with PHPT. Seventy-six patients who had positive parathyroid scintigraphy and who did not undergo parathyroidectomy in our center due to various reasons were excluded...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29302491/an-ectopic-intrathyroidal-thymic-tissue-and-intrathymic-parathyroid-tissue-in-a-patient-with-graves-disease
#5
Kelly O'Connor, Hassan Alzahrani, Fadi Murad, Philip Daroca, Emad Kandil
Ectopic intrathyroidal thymic tissue, with coinciding intrathymic parathyroid tissue, is a very rare occurrence that is most often found incidentally in adults during surgery. We report a 23-year-old female who presented with Graves disease refractory to medical treatment. Radioactive iodine uptake demonstrated increased, diffuse uptake in the region of the thyroid. The patient underwent a total thyroidectomy and right inferior parathyroidectomy which was found enlarged intraoperatively. Histopathologically, surgical specimen demonstrated characteristics of intrathyroidal thymic tissue and intrathymic parathyroid tissue...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302484/inadvertent-parathyroidectomy-risk-factors-in-1-373-thyroidectomies-male-gender-and-presence-of-lymphadenopathy-but-not-size-of-gland-independently-increase-the-risk
#6
Ioannis Christakis, Penny Zacharopoulou, Georgios Galanopoulos, Ilias-Demetrios Kafetzis, Spiros Dimas, Nikolaos Roukounakis
Background: Inadvertent parathyroidectomy (IP) during thyroid operations is a recognised phenomenon. We evaluated the incidence of IP during thyroid operations in a large case-series and identified the risk factors involved. Methods: Retrospective review of all thyroidectomy operations [total thyroidectomies (TT) and near-total thyroidectomies (NTT)] performed in a single institution from January 2004 to January 2009. We excluded re-operative cases, combined thyroid and parathyroid pathology, hemithyroidectomies and neck lymph nodes (LN) dissections...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302479/near-total-parathyroidectomy-for-the-treatment-of-renal-hyperparathyroidism
#7
Marco Puccini, Cristina Ceccarelli, Ophelia Meniconi, Claudia Zullo, Valerio Prosperi, Mario Miccoli, Lucio Urbani, Piero Buccianti
Background: Different surgical strategies are used to treat medical refractory renal hyperparathyroidism. Our preferred choice in patients with moderate secondary hyperparathyroidism (SHPT) and in patients with low compliance with medical treatment is to leave a very small parathyroid remnant in situ: we name this operation "near total parathyroidectomy" (ntPTX). We report here our results with this technique. Methods: Retrospective study [2001-2015] of all patients submitted to ntPTX in a single centre...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29301864/effect-of-autotransplantation-of-a-parathyroid-gland-on-hypoparathyroidism-after-total-thyroidectomy
#8
Anping Su, Yanping Gong, Wenshuang Wu, Rixiang Gong, Zhihui Li, Jingqiang Zhu
BACKGROUND: The effect of parathyroid autotransplantation on hypoparathyroidism is not fully understood. The purpose of the study was to determine the effect of autotransplantation of a parathyroid gland on the incidence of hypoparathyroidism and recovery of parathyroid function at 6 months after total thyroidectomy with central neck dissection for papillary thyroid carcinoma. METHODS: All patients with autotransplantation of a parathyroid gland (no inadvertent parathyroidectomy) (group A), in situ preservation of all parathyroid glands (no autotransplantation and inadvertent parathyroidectomy) (group B), or inadvertent removal of a parathyroid gland (no autotransplantation) (group C) who underwent first-time total thyroidectomy with central neck dissection for papillary thyroid carcinoma between January 2013 and June 2016 were included retrospectively...
January 4, 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29284591/timing-of-parathyroidectomy-in-kidney-transplant-candidates-with-secondary-hyperparathryroidism-effect-of-pretransplant-versus-early-or-late-post-transplant-parathyroidectomy
#9
Simon A Littbarski, Alexander Kaltenborn, Jill Gwiasda, Jan Beneke, Viktor Arelin, Ysabell Schwager, Julia V Stupak, Indra L Marcheel, Nikos Emmanouilidis, Mark D Jäger, Georg Friedrich Wilhelm Scheumann, Jürgen Klempnauer, Harald Schrem
BACKGROUND: The timing of parathyroidectomy in kidney transplant candidates suffering from secondary hyperparathyroidism before versus early or late after transplantation remains controversial. METHODS: The short-term follow-up cohort comprised 66 patients with 1-year post-transplant follow-up, while the long-term follow-up cohort contained 123 patients. Risk-adjusted identification of independent risk factors for compromised renal graft function (KDIGO stage ≥ IV) was performed using multivariable regression analysis adjusted for propensity score logits for parathyroidectomy before versus after renal transplantation...
December 25, 2017: Surgery
https://www.readbyqxmd.com/read/29280194/effect-of-prophylactic-calcitriol-administration-on-serum-ionized-calcium-concentrations-after-parathyroidectomy-78-cases-2005-2015
#10
A J Armstrong, J G Hauptman, B J Stanley, E Klocke, M Burneko, D E Holt, J J Runge, J A Rubin
BACKGROUND: Prophylactic administration of calcitriol has been suggested to mitigate the risk of hypocalcemia after parathyroidectomy. The effect of calcitriol on postoperative serum ionized calcium concentrations has not been evaluated in dogs after parathyroidectomy. HYPOTHESIS/OBJECTIVES: To determine the effect of prophylactic calcitriol administration on postoperative serum ionized calcium (iCa) concentrations in dogs with primary hyperthyroidism (PHPTH) treated by parathyroidectomy...
December 27, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29276732/normocalcemic-primary-hyperparathyroidism-associated-with-progressive-cortical-bone-loss-a-case-report
#11
Joseph R Tucci
The existence of normocalcemic primary hyperparathyroidism (NPHP) was acknowledged at the Third and Fourth International Proceedings on primary hyperparathyroidism PHPT but data relating to its clinical presentation, natural history, and skeletal status were limited and there was no information nor guidelines as to definitive therapy. Herein are reported biochemical, hormonal, and densitometry data in a postmenopausal woman seen initially for osteoporosis who was found to have increased serum PTH levels and normal serum total and ionized calcium levels without evidence of secondary hyperparathyroidism...
December 2017: Bone Reports
https://www.readbyqxmd.com/read/29273178/successful-parathyroidectomy-guided-by-intraoperative-parathyroid-hormone-monitoring-for-primary-hyperparathyroidism-is-preserved-in-mild-and-moderate-renal-insufficiency
#12
Andrea R Marcadis, Richard Teo, Wenqi Ouyang, Josefina C Farrá, John I Lew
BACKGROUND: The effect of altered parathyroid hormone metabolism in renal insufficiency on intraoperative parathyroid hormone monitoring during parathyroidectomy is not well known. This study evaluates operative outcomes in patients undergoing parathyroidectomy guided by intraoperative parathyroid hormone monitoring for primary hyperparathyroidism with mild and moderate renal insufficiency. METHODS: A retrospective review of prospectively collected data in 604 patients with sporadic primary hyperparathyroidism undergoing parathyroidectomy guided by intraoperative parathyroid hormone monitoring was performed...
December 19, 2017: Surgery
https://www.readbyqxmd.com/read/29261624/hyperparathyroidism-caused-by-coexisting-parathyroid-hyperplasia-and-ectopic-parathyroid-adenomas
#13
Peng Xie, Jianmin Huang
Tc sestamibi parathyroid scan was performed in a 35-year-old man with chronic renal failure to evaluate the cause of increased serum parathyroid hormone. Both early and delayed images showed intense activity overlapping the left upper pole of the thyroid, which was proven to be nodular parathyroid hyperplasia after parathyroidectomy. However, the levels of serum parathyroid hormone remained elevated postsurgically. A repeat sestamibi study revealed abnormal activity in the left upper mediastinum, which could also be subtly seen on initial sestamibi study...
December 19, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29245308/total-parathyroidectomy-with-forearm-auto-transplantation-improves-the-quality-of-life-and-reduces-the-recurrence-of-secondary-hyperparathyroidism-in-chronic-kidney-disease-patients
#14
COMPARATIVE STUDY
Jia-Gen Li, Zhang-Sheng Xiao, Xian-Jie Hu, Yun Li, Xing Zhang, Song-Ze Zhang, Ai-Qin Shan
BACKGROUND: Our study aims to explore the effect of total parathyroidectomy (PTX) with forearm autotransplantation (FAT) on the quality of life and recurrence of secondary hyperparathyroidism (SHPT) in chronic kidney disease patients. METHODS: A total of 104 chronic kidney disease patients with SHPT were enrolled and divided into the PTX (n = 62) and PTX + FAT (n = 42) groups. The operation efficacy was evaluated by analyzing preoperative and postoperative values, including levels of intact parathyroid hormone (iPTH), serum phosphorus, serum calcium, alkaline phosphatase (ALP), calcium-phosphorus product, signs and symptoms, and MOS 36-item short-form health survey (SF-36) scores...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29241464/-diagnostic-approach-and-treatment-of-primary-hyperparathyroidism
#15
W Y van der Plas, M E Noltes, A W M A Schaeffers, A H Brouwers, A N A van der Horst-Schrivers, S Kruijff
- Primary hyperparathyroidism (PHPT) is characterised by elevated serum calcium levels due to elevated levels, or insufficient suppression, of parathyroid hormone (PTH).- The incidence of PHPT has increased in recent years. This is mainly the result of more frequently performed routine measurements of serum calcium, e.g. as part of postmenopausal screening.- The classically described features of PHPT - bones and stones - are not always observed and most patients are asymptomatic.- Diagnosis of PHPT is only established by biochemical testing, not by imaging...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29238977/microinvasive-parathyroidectomy-incremental-improvement-in-minimally-invasive-parathyroid-surgery
#16
Seth Kay, Jeremy Godsell, Luke Edelmayer, David J Terris
No abstract text is available yet for this article.
December 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29238762/etelcalcetide-injectable-calcimimetic-for-the-treatment-of-secondary-hyperparathyroidism-in-hemodialysis-dependent-patients
#17
P A Ureña Torres, J Bover, M Cohen-Solal
Chronic kidney disease is associated with mineral and bone disorders that are now considered as a syndrome. One of the major complications of this syndrome is secondary hyperparathyroidism (SHPT). SHPT increases bone turnover and the risk of fracture. SHPT is also associated with cardiovascular calcification and high mortality risk. The classical medical therapies of SHPT lack long-term efficacy and have undesirable effects on serum calcium and phosphate levels. Surgical parathyroidectomy is a radical therapeutic solution potentially exposing patients to a permanent state of hypoparathyroidism among other complications...
September 2017: Drugs of Today
https://www.readbyqxmd.com/read/29238129/persistent-hypocalcemia-and-hungry-bone-syndrome-after-parathyroidectomy-and-renal-transplantation-in-a-patient-with-end-stage-renal-disease
#18
Hamid Tayyebi-Khosroshahi, Farahnoush Farnood, Maryam Ghorbanian, Farid Karkon-Shayan, Mohammad Naghavi-Behzad
Hungry bone syndrome (HBS) defines as persistent and severe hypocalcemia after parathyroidectomy surgery. It is treated by oral or venous discrimination of calcium carbonate. The present treatment is mostly effective. Hereby, we describe a 60-year-old man who had developed hyperparathyroidism secondary to end-stage renal disease and then parathyroidectomy was performed for him twice before renal transplantation. Up to 500 vials of calcium gluconate (100 mg/ml calcium gluconate 10%) were administered for him to control serum calcium level after parathyroidectomy and renal transplantation...
January 2017: Nigerian Medical Journal: Journal of the Nigeria Medical Association
https://www.readbyqxmd.com/read/29235733/intraoperative-parathyroid-aspiration-and-parathyroid-hormone-assay-during-parathyroidectomy-for-primary-hyperparathyroidism
#19
Miki Paker, Shani Fisher, Salim Mazzawi, Raul Kolodner, Dror Ashkenazi
BACKGROUND: Direct aspiration from suspected pathological tissue and rapid parathyroid hormone analysis may offer a reliable, cost effective alternative to currently used "gold standard" tests. OBJECTIVES: To validate the accuracy of intraoperative measurements of parathyroid hormone levels in parathyroid adenomas. METHODS: A prospective study included 22 patients diagnosed with primary hyperparathyroidism who underwent parathyroidectomy due to an adenoma or hyperplasia...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29234569/a-case-of-localized-pulmonary-calcification-presenting-as-a-persistent-mass-lesion-in-an-immunosuppressed-patient-following-treatment-of-a-pseudomonas-pneumonia
#20
Matthew J Cecchini, Dominic L Shepherd, Jessica G Shepherd
We report a case of a persistent right upper lobe opacity following treatment for a Pseudomonas infection in an immunosuppressed patient with a recent renal transplantation. The patient underwent a surgical lung biopsy for definitive diagnosis of the mass. The lesion was composed of extensive calcifications deposited throughout the lung with associated fibrosis. The patient had a history of a remote parathyroidectomy for hyperparathyroidism; however, the parathyroid hormone (PTH) and the calcium levels were still mildly elevated...
October 11, 2017: Curēus
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