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Parathyroid surgery

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https://www.readbyqxmd.com/read/29341944/nuclear-medicine-methods-for-evaluation-of-abnormal-parathyroid-glands-in-patients-with-primary-and-secondary-hyperparathyroidism
#1
Albena D Botushanova, Nikolay P Botushanov, Marianna P Yaneva
Considered rare disease in the past, primary hyperparathyroidism (PHPT) has dramatically increased in incidence over the past thirty years with the introduction of routine calcium measurements; it is now approximately 42 per 100 000 persons. By far, the most common lesion found in patients with PHPT is the solitary parathyroid adenoma, occurring in 85%-90% of patients, while in the rest 10%- 15% primary hyperplasia of the parathyroid glands is present. Currently, the most widely used surgical approach is minimally invasive parathyroidectomy which is associated with less post-surgery complications and shorter operation time...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29340678/lifestyle-intervention-and-medical-management-with-vs-without-roux-en-y-gastric-bypass-and-control-of-hemoglobin-a1c-ldl-cholesterol-and-systolic-blood-pressure-at-5-years-in-the-diabetes-surgery-study
#2
COMMENT
Sayeed Ikramuddin, Judith Korner, Wei-Jei Lee, Avis J Thomas, John E Connett, John P Bantle, Daniel B Leslie, Qi Wang, William B Inabnet, Robert W Jeffery, Keong Chong, Lee-Ming Chuang, Michael D Jensen, Adrian Vella, Leaque Ahmed, Kumar Belani, Charles J Billington
Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29336900/combined-use-of-a-nanocarbon-suspension-and-99mtc-mibi-for-the-intra-operative-localization-of-the-parathyroid-glands
#3
Jun Chen, Qinyi Zhou, Jialin Feng, Jiadong Wang
OBJECTIVE: To investigate the combined use of a nanocarbon (NC) suspension and low-dose 99mTc-MIBI for parathyroid localization during surgery in patients with secondary hyperparathyroidism (sHPT). METHODS: Between March 2010 and September 2015, 40 patients with sHPT were enrolled in this study and were randomized to receive either low-dose 99mTc-MIBI+NC (group I) or low-dose 99mTc-MIBI (group II). Pre- and post-operative serum levels of intact PTH (iPTH), calcium and phosphorus between groups were compared and the intra-operative radioactive counts of the parathyroid glands were measured...
December 13, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29336756/risk-factors-for-elevated-preoperative-alkaline-phosphatase-in-patients-with-refractory-secondary-hyperparathyroidism
#4
Meng Yang, Ling Zhang, Linping Huang, Xiaoliang Sun, Haoyang Ji, Yao Lu
Elevated preoperative levels of alkaline phosphatase (ALP) in patients with refractory secondary hyperparathyroidism are correlated with postoperative hypocalcemia and mortality. The aim of this study was to identify the predictors of preoperative ALP in patients with secondary hyperparathyroidism. From April 2012 to December 2015, 220 patients with refractory secondary hyperparathyroidism undergoing total parathyroidectomy without autotransplantation were reviewed. A total of 164 patients presented with elevated preoperative ALP...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29322299/serum-parathyroid-hormone-and-25-hydroxyvitamin-d-concentrations-before-and-after-biliopancreatic-diversion
#5
Vanessa Tardio, Jean-Philippe Blais, Anne-Sophie Julien, Pierre Douville, Stefane Lebel, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Claudia Gagnon
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) decreases vitamin D and calcium absorption, which may result in secondary hyperparathyroidism. This study aimed at evaluating the prevalence of vitamin D deficiency and secondary hyperparathyroidism before and after BPD-DS. METHODS: A retrospective analysis of patients who had undergone BPD-DS at a tertiary bariatric center between 2003 and 2010 and for whom simultaneous measurements of serum 25-hydroxyvitamin D and parathyroid hormone were available within 5 years post-op was performed...
January 10, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29322026/the-pgris-and-parathyroid-splinting-concepts-for-the-analysis-and-prognosis-of-protracted-hypoparathyroidism
#6
Antonio Sitges-Serra
Most patients with hypocalcemia after total thyroidectomy will recover the parathyroid function in a few weeks, but some 20-30% of them will still be in the need for replacement therapy one month after surgery and about 5-10% of those will develop permanent hypoparathyroidism. Although postoperative hypocalcemia has been related to several demographic and metabolic causes, parathyroid hormone (PTH) decline, resulting from autotransplantation, inadvertent excision or devascularization of the parathyroid glands, is the common final pathway...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322025/short-and-long-term-impact-of-parathyroid-autotransplantation-on-parathyroid-function-after-total-thyroidectomy
#7
REVIEW
Gabrielle Hicks, Robert George, Mark Sywak
The most common complication of total thyroidectomy is parathyroid insufficiency. Acute, transient, post-operative hypoparathyroidism increases length of hospitalization, morbidity and cost associated with total thyroidectomy. While permanent hypoparathyroidism poses a significant medical burden with lifetime medication, regular follow up and considerable disease burden related to chronic renal failure and other sequelae. Parathyroid autotransplantation has been demonstrated to result in biochemically functional grafts, leading to the procedures' common use during total thyroidectomy...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322023/incidence-prevalence-and-risk-factors-for-post-surgical-hypocalcaemia-and-hypoparathyroidism
#8
REVIEW
Ovie Edafe, Sabapathy Prakash Balasubramanian
Hypocalcaemia following thyroid surgery is common and is associated with significant short and long term morbidity. Damage to or devascularisation of parathyroid glands is the predominant underlying mechanism; although other factors such as hungry bone syndrome may occasionally contribute to it in the immediate post-operative period. The reported incidence of post-surgical hypocalcaemia and/or hypoparathyroidism (PoSH) varies significantly in the literature; the variation thought to be at least partly due to differences in the definitions used...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322020/a-reappraisal-of-vascular-anatomy-of-the-parathyroid-gland-based-on-fluorescence-techniques
#9
REVIEW
Samira Mercedes Sadowski, Jordi Vidal Fortuny, Frederic Triponez
Identification of the parathyroid glands (PGs) during thyroid surgery may prevent their inadvertent surgical removal and prevent postoperative hypoparathyroidism. However, identification of the PGs does not guarantee their function, and their vascular supply needs to be preserved as well. The recent introduction of intraoperative indocyanine green (ICG) fluorescent angiography of the PGs during thyroid surgery allows for the appraisal of the vascular anatomy and evaluation of PG function. The use of this tool could lead to a significant reduction in the rate of postoperative hypoparathyroidism, as it allows surgeons to adapt their surgical technique for the preservation of the PGs...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322019/to-identify-or-not-to-identify-parathyroid-glands-during-total-thyroidectomy
#10
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/29322018/a-nomogram-to-predict-the-likelihood-of-permanent-hypoparathyroidism-after-total-thyroidectomy-based-on-delayed-serum-calcium-and-ipth-measurements
#11
Antonio Sitges-Serra, Joaquín Gómez, Marcin Barczynski, Leyre Lorente-Poch, Maurizio Iacobone, Juan Sancho
Background: Retrospective studies have shown that delayed high-normal serum calcium and detectable iPTH are independent variables positively influencing outcome of prolonged parathyroid failure after total thyroidectomy (TT). The aim of the present study was to examine prospectively the ability of these two variables to predict permanent hypoparathyroidism in patients under replacement therapy for postoperative hypocalcemia. Methods: Prospective observational multicenter study of patients undergoing TT followed by postoperative parathyroid failure (serum calcium <8 mg/dL within 24 h and PTH <15 pg/mL 4 h after surgery)...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322017/clinical-profile-and-long-term-follow-up-of-32-patients-with-postoperative-permanent-hypoparathyroidism
#12
Leyre Lorente-Poch, Juan J Sancho, Leticia Carballo, Antonio Sitges-Serra
Background: Parathyroid failure is the most common complication after total thyroidectomy but permanent impairment of the parathyroid function is unusual. Limited data is available assessing long-term follow-up, quality of life and complications occurring in patients with permanent hypoparathyroidism (PH). We aimed to assess the incidence of complications derived from PH status, their influence on the quality of life perceived by PH patients and its relation to standard medical treatment with calcium salts and active vitamin D analogues...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29319134/diagnostic-accuracy-of-planar-spect-and-spect-ct-parathyroid-scintigraphy-protocols-in-patients-with-hyperparathyroidism
#13
Yutapong Raruenrom, Daris Theerakulpisut, Nantaporn Wongsurawat, Charoonsak Somboonporn
BACKGROUND: Several parathyroid scintigraphy protocols have been used for preoperative localization of hyperfunctioning parathyroid glands in patients with hyperparathyroidism. The aim of this study is to compare the diagnostic accuracy of various parathyroid scintigraphy protocols. MATERIAL AND METHODS: A retrospective diagnostic accuracy study with histopathology as the reference standard was done. Five imaging protocols were investigated including planar dual tracer Tc-99m pertechnetate/Tc-99m sestamibi (DT), planar dual phase Tc-99m sestamibi (DP), and combined dual tracer dual phase (DTDP) protocols, as well as add-on single photon emission computed tomography (SPECT), and single photon emission computed tomography/computed tomography (SPECT/CT)...
January 10, 2018: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/29312723/comparison-of-video-assisted-thoracic-surgery-with-open-surgery-in-the-treatment-of-ectopic-mediastinal-parathyroid-tumors
#14
Hailei Du, Minmin Shi, Lianggang Zhu, Jiamin Che, Junbiao Hang, Zhongyuan Chen, Hecheng Li
Background: To investigate the therapeutic effect of different surgical treatment for ectopic mediastinal parathyroid tumors and pathological features. Methods: A total of 21 patients who were diagnosed with ectopic mediastinal parathyroid tumors and underwent surgeries in our department from May 1995 to May 2015 were collected and retrospectively analyzed. Results: Twenty-one patients including 8 female (36.4%) and 13 male (63.6%) were collected...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29302725/does-surgery-without-lugol-s-solution-pretreatment-for-graves-disease-increase-surgical-morbidity
#15
Frederic Mercier, Mathieu Bonnal, Florian Fanget, Laure Maillard, Nathalie Laplace, Jean-Louis Peix, Jean-Christophe Lifante
BACKGROUND: Total thyroidectomy can be performed for Graves' disease after a euthyroid state is achieved using inhibitors of thyroid hormone synthesis (thioamides). However, hypervascularization of the thyroid gland is associated with increased hemorrhage risk, in addition to complicating identification of the recurrent laryngeal nerve and parathyroid gland. Saturated iodine solution (Lugol's solution) has been recommended to reduce thyroid gland hypervascularization and intraoperative blood loss, although this approach is not used at our center based on our experience that it induces thyroid firmness and potentially hypoparathyroidism...
January 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29302491/an-ectopic-intrathyroidal-thymic-tissue-and-intrathymic-parathyroid-tissue-in-a-patient-with-graves-disease
#16
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/29299645/transcutaneous-laryngeal-ultrasonography-for-laryngeal-immobility-diagnosis-in-patients-with-voice-disorders-after-thyroid-parathyroid-surgery
#17
Diane S Lazard, Héloïse Bergeret-Cassagne, Muriel Lefort, Laurence Leenhardt, Gilles Russ, Frédérique Frouin, Christophe Trésallet
BACKGROUND: Transcutaneous laryngeal ultrasonography (TLUS) was recently developed to assess recurrent nerve palsy after thyroid/parathyroid surgery, with variable rates of efficiency. The aim of the current study was to evaluate this technique using subjective estimation and post-processing quantitative data. METHODS: Fifty subjects presenting with a recurrent nerve palsy and 50 "controls" presenting with voice, swallowing, or breathing disorders following thyroid/parathyroid surgery were prospectively included...
January 3, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29280705/non-functioning-parathyroid-cystic-tumour-malignant-or-not-report-of-a-case
#18
G Cocorullo, G Scerrino, G Melfa, C Raspanti, G Rotolo, V Mannino, P Richiusa, D Cabibi, A G Giannone, C Porrello, G Gulotta
Parathyroid carcinoma (PC) is a very rare endocrine tumour, usually characterized by symptoms such as a neck mass, dysphonia, severe hypercalcemia exceeding 140 mg/L and elevated serum parathyroid hormone levels, even more than 5 times the upper limit of normal. Non-functioning parathyroid cancer is extremely rare and, in this case, its pre-operative diagnosis is often difficult. A 54-year old female patient, referring dysphagia and dysphonia, underwent neck ultrasound and neck CT. A left thyroid nodule, probably cystic, was found...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29280194/effect-of-prophylactic-calcitriol-administration-on-serum-ionized-calcium-concentrations-after-parathyroidectomy-78-cases-2005-2015
#19
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/29275894/ambulatory-surgery-under-local-anesthesia-for-parathyroid-adenoma-feasibility-and-outcome
#20
A Benhami, E Chuffart, N Christou, S Liva-Yonnet, M Mathonnet
The aim of this study was to evaluate the results of ambulatory parathyroid resection performed under local anesthesia (LA). MATERIAL AND METHODS: Outpatients undergoing parathyroid adenoma resection by a focused approach under LA were included. Results were evaluated by intraoperative serum parathormone levels (ioPTH) and the balance of phosphate and calcium postoperatively, at 3 months, 1 year and at the point date. The quality of ambulatory care was evaluated by the number of cancelled interventions, the number of patients hospitalized after surgery or during the first postoperative month...
December 21, 2017: Journal of Visceral Surgery
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