Changing practices in the surgical management of hyperparathyroidism - A 10-year review.

Hdl Handle:
http://hdl.handle.net/10147/206207
Title:
Changing practices in the surgical management of hyperparathyroidism - A 10-year review.
Affiliation:
Department of Surgery, Galway University Hospital, Galway, Ireland.
Citation:
Surgeon. 2011 Nov 19.
Journal:
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206207
DOI:
10.1016/j.surge.2011.10.005
PubMed ID:
22105046
Abstract:
AIM: Parathyroid surgery has undergone a paradigm shift over the last decade, with a move from traditional bilateral neck exploration to minimally invasive parathyroidectomy (MIP), and increasing reliance on pre- and intra-operative localization of overactive glands. We aimed to assess changing surgical practices and their impact on the management of parathyroid disease in a tertiary referral centre in the West of Ireland. METHODS: A retrospective cohort analysis of those patients undergoing a surgical intervention for parathyroid disease in the period between 1999 and 2009 in our centre was carried out. Data was analysed using PASW (v18) software. RESULTS: 248 procedures were performed, increasing from an annual rate of 6 in 1999 to 45 in 2009. 129 procedures were completed by minimally invasive means, following the introduction of MIP in 2003. Single-gland disease accounted for 87% of cases (n = 216) with carcinomas in 2 patients (0.8%). Pre-operative localization had disappointing diagnostic value, with high false negative rates for both ultrasound (37.3%) and Sestamibi Scanning (35.81%). Intra-operative adjuncts were more helpful, with intra-operative Parathyroid hormone monitoring facilitating curative resection of adenomas in 94.03% at 10 min. Median length of post-operative stay has significantly decreased from 6 days in 1999 to 1 night only in 2009 (p < 0.01, ANOVA). Those patients undergoing MIP had shorter stay than the open group (1.71 days -v-4.73, p = 0.003,t-test). CONCLUSION: The practice in our centre has shifted to a less invasive approach. Increased utilisation of intra-operative adjuncts has facilitated this change, and resulted in favourable changes in length of stay, extent of dissection, and number of patients treated.
Language:
ENG
ISSN:
1479-666X (Electronic); 1479-666X (Linking)

Full metadata record

DC FieldValue Language
dc.date.accessioned2012-01-31T16:35:21Z-
dc.date.available2012-01-31T16:35:21Z-
dc.date.issued2012-01-31T16:35:21Z-
dc.identifier.citationSurgeon. 2011 Nov 19.en_GB
dc.identifier.issn1479-666X (Electronic)en_GB
dc.identifier.issn1479-666X (Linking)en_GB
dc.identifier.pmid22105046en_GB
dc.identifier.doi10.1016/j.surge.2011.10.005en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206207-
dc.description.abstractAIM: Parathyroid surgery has undergone a paradigm shift over the last decade, with a move from traditional bilateral neck exploration to minimally invasive parathyroidectomy (MIP), and increasing reliance on pre- and intra-operative localization of overactive glands. We aimed to assess changing surgical practices and their impact on the management of parathyroid disease in a tertiary referral centre in the West of Ireland. METHODS: A retrospective cohort analysis of those patients undergoing a surgical intervention for parathyroid disease in the period between 1999 and 2009 in our centre was carried out. Data was analysed using PASW (v18) software. RESULTS: 248 procedures were performed, increasing from an annual rate of 6 in 1999 to 45 in 2009. 129 procedures were completed by minimally invasive means, following the introduction of MIP in 2003. Single-gland disease accounted for 87% of cases (n = 216) with carcinomas in 2 patients (0.8%). Pre-operative localization had disappointing diagnostic value, with high false negative rates for both ultrasound (37.3%) and Sestamibi Scanning (35.81%). Intra-operative adjuncts were more helpful, with intra-operative Parathyroid hormone monitoring facilitating curative resection of adenomas in 94.03% at 10 min. Median length of post-operative stay has significantly decreased from 6 days in 1999 to 1 night only in 2009 (p < 0.01, ANOVA). Those patients undergoing MIP had shorter stay than the open group (1.71 days -v-4.73, p = 0.003,t-test). CONCLUSION: The practice in our centre has shifted to a less invasive approach. Increased utilisation of intra-operative adjuncts has facilitated this change, and resulted in favourable changes in length of stay, extent of dissection, and number of patients treated.en_GB
dc.language.isoENGen_GB
dc.titleChanging practices in the surgical management of hyperparathyroidism - A 10-year review.en_GB
dc.contributor.departmentDepartment of Surgery, Galway University Hospital, Galway, Ireland.en_GB
dc.identifier.journalThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Irelanden_GB
dc.description.provinceConnacht-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.