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The role of preoperative localization in primary hyperparathyroidism. 1995

E C Lundgren, and A R Gillott, and J S Wiseman, and J Beck
Guthrie Clinic, Sayre, Pennsylvania 18840, USA.

Hyperparathyroidism is being increasingly recognized by the detection of hypercalcemia on routine blood chemistry. Improvement in preoperative localization has been proposed as a way to decrease operative time and decrease morbidity and mortality. The purpose of this study was to retrospectively review the Guthrie Clinic experience of parathyroidectomy with and without preoperative localization. One hundred nineteen patients who presented with primary hyperparathyroidism between 1983 and 1990 were evaluated. There were 27 males and 91 females with an average age of 61. Preoperative localization resulted in a significant decrease in operative time with preoperative localization decreasing operative time from 97 minutes without localization to 70 minutes with localization. Also, complications were less in patients undergoing preoperative localization (5.8% versus 13.9%). Preoperative localization was positively affected by gland size, with larger glands being easier to localized. In conclusion, accurate preoperative localization decreases operative time and decreases complications in this series of patients undergoing exploration for primary hyperparathyroidism. In our institution the thallium technitium scan is most accurate and is the localization procedure of choice.

UI MeSH Term Description Entries
D006961 Hyperparathyroidism A condition of abnormally elevated output of PARATHYROID HORMONE (or PTH) triggering responses that increase blood CALCIUM. It is characterized by HYPERCALCEMIA and BONE RESORPTION, eventually leading to bone diseases. PRIMARY HYPERPARATHYROIDISM is caused by parathyroid HYPERPLASIA or PARATHYROID NEOPLASMS. SECONDARY HYPERPARATHYROIDISM is increased PTH secretion in response to HYPOCALCEMIA, usually caused by chronic KIDNEY DISEASES.
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009929 Organ Size The measurement of an organ in volume, mass, or heaviness. Organ Volume,Organ Weight,Size, Organ,Weight, Organ
D010280 Parathyroid Glands Two pairs of small oval-shaped glands located in the front and the base of the NECK and adjacent to the two lobes of THYROID GLAND. They secrete PARATHYROID HORMONE that regulates the balance of CALCIUM; PHOSPHORUS; and MAGNESIUM in the body. Gland, Parathyroid,Glands, Parathyroid,Parathyroid Gland
D010282 Parathyroid Neoplasms Tumors or cancer of the PARATHYROID GLANDS. Cancer of Parathyroid,Parathyroid Cancer,Cancer of the Parathyroid,Neoplasms, Parathyroid,Parathyroid Adenoma,Parathyroid Carcinoma,Adenoma, Parathyroid,Adenomas, Parathyroid,Cancer, Parathyroid,Cancers, Parathyroid,Carcinoma, Parathyroid,Carcinomas, Parathyroid,Neoplasm, Parathyroid,Parathyroid Adenomas,Parathyroid Cancers,Parathyroid Carcinomas,Parathyroid Neoplasm
D010710 Phosphates Inorganic salts of phosphoric acid. Inorganic Phosphate,Phosphates, Inorganic,Inorganic Phosphates,Orthophosphate,Phosphate,Phosphate, Inorganic
D011300 Preoperative Care Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed) Care, Preoperative,Preoperative Procedure,Preoperative Procedures,Procedure, Preoperative,Procedures, Preoperative
D002712 Chlorides Inorganic compounds derived from hydrochloric acid that contain the Cl- ion. Chloride,Chloride Ion Level,Ion Level, Chloride,Level, Chloride Ion
D005260 Female Females

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