Long-term outcome in patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy

Raghunandan Venkat, Guennadi Kouniavsky, Ralph P. Tufano, Eric B. Schneider, Alan P B Dackiw, Martha A. Zeiger

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21 Citations (Scopus)

Abstract

Background Minimally invasive parathyroidectomy (MIP) has become a well-accepted treatment for selected patients with primary hyperparathyroidism (PHPT). However, few studies have evaluated long-term outcomes for this operative approach. We therefore chose to examine both the long-term symptom resolution and biochemical cure following MIP for PHPT. Methods A total of 460 PHPT patients who underwent a MIP between 2004 and 2009 were successfully mailed a questionnaire that assessed preoperative and postoperative Parathyroidectomy Assessment of Symptoms (PAS) scores, most recent calcium and parathyroid hormone (PTH) levels, and information about any reoperation for PHPT. Long-term evaluation of symptomatic and biochemical cure was performed. Results A total of 200 patients (43.5%) responded to our correspondence. The mean age of the patients was 58.7 ± 11.9 years, 74.5% were female, and 78.5% were Caucasian. The mean follow-up was 37 ± 19 months. The mean PAS scores fell by 117 ± 14 at long-term follow-up afterMIP (P\0.0001). All 13 symptoms comprising thePAS score diminished, ofwhich ten did so significantly (P\0.01). There was a significant drop in the mean serum calcium (preop. 11.1 mg/dl, postop. 9.6 mg/dl; P\0.0001) and PTH (preop. 130.9 pg/ml, postop. 45.7 pg/ml;P\0.0001) at longterm follow-up. Five patients (2.5%) developed recurrent disease (calcium[10.5 mg/dl), and one (0.5%) underwent a reoperation for persistent disease andwas subsequently cured. Conclusions This study demonstrates that MIP has longterm benefits in terms of excellent symptom resolution and a high biochemical cure rate (97%) in selected patients who have PHPT, preoperative localization with sestamibi scans, and assessment of intraoperative PTH level.

Original languageEnglish (US)
Pages (from-to)55-60
Number of pages6
JournalWorld Journal of Surgery
Volume36
Issue number1
DOIs
StatePublished - 2012

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Parathyroidectomy
Primary Hyperparathyroidism
Parathyroid Hormone
Symptom Assessment
Calcium
Reoperation
Serum

ASJC Scopus subject areas

  • Surgery

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Long-term outcome in patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy. / Venkat, Raghunandan; Kouniavsky, Guennadi; Tufano, Ralph P.; Schneider, Eric B.; Dackiw, Alan P B; Zeiger, Martha A.

In: World Journal of Surgery, Vol. 36, No. 1, 2012, p. 55-60.

Research output: Contribution to journalArticle

Venkat, Raghunandan ; Kouniavsky, Guennadi ; Tufano, Ralph P. ; Schneider, Eric B. ; Dackiw, Alan P B ; Zeiger, Martha A. / Long-term outcome in patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy. In: World Journal of Surgery. 2012 ; Vol. 36, No. 1. pp. 55-60.
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abstract = "Background Minimally invasive parathyroidectomy (MIP) has become a well-accepted treatment for selected patients with primary hyperparathyroidism (PHPT). However, few studies have evaluated long-term outcomes for this operative approach. We therefore chose to examine both the long-term symptom resolution and biochemical cure following MIP for PHPT. Methods A total of 460 PHPT patients who underwent a MIP between 2004 and 2009 were successfully mailed a questionnaire that assessed preoperative and postoperative Parathyroidectomy Assessment of Symptoms (PAS) scores, most recent calcium and parathyroid hormone (PTH) levels, and information about any reoperation for PHPT. Long-term evaluation of symptomatic and biochemical cure was performed. Results A total of 200 patients (43.5{\%}) responded to our correspondence. The mean age of the patients was 58.7 ± 11.9 years, 74.5{\%} were female, and 78.5{\%} were Caucasian. The mean follow-up was 37 ± 19 months. The mean PAS scores fell by 117 ± 14 at long-term follow-up afterMIP (P\0.0001). All 13 symptoms comprising thePAS score diminished, ofwhich ten did so significantly (P\0.01). There was a significant drop in the mean serum calcium (preop. 11.1 mg/dl, postop. 9.6 mg/dl; P\0.0001) and PTH (preop. 130.9 pg/ml, postop. 45.7 pg/ml;P\0.0001) at longterm follow-up. Five patients (2.5{\%}) developed recurrent disease (calcium[10.5 mg/dl), and one (0.5{\%}) underwent a reoperation for persistent disease andwas subsequently cured. Conclusions This study demonstrates that MIP has longterm benefits in terms of excellent symptom resolution and a high biochemical cure rate (97{\%}) in selected patients who have PHPT, preoperative localization with sestamibi scans, and assessment of intraoperative PTH level.",
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AB - Background Minimally invasive parathyroidectomy (MIP) has become a well-accepted treatment for selected patients with primary hyperparathyroidism (PHPT). However, few studies have evaluated long-term outcomes for this operative approach. We therefore chose to examine both the long-term symptom resolution and biochemical cure following MIP for PHPT. Methods A total of 460 PHPT patients who underwent a MIP between 2004 and 2009 were successfully mailed a questionnaire that assessed preoperative and postoperative Parathyroidectomy Assessment of Symptoms (PAS) scores, most recent calcium and parathyroid hormone (PTH) levels, and information about any reoperation for PHPT. Long-term evaluation of symptomatic and biochemical cure was performed. Results A total of 200 patients (43.5%) responded to our correspondence. The mean age of the patients was 58.7 ± 11.9 years, 74.5% were female, and 78.5% were Caucasian. The mean follow-up was 37 ± 19 months. The mean PAS scores fell by 117 ± 14 at long-term follow-up afterMIP (P\0.0001). All 13 symptoms comprising thePAS score diminished, ofwhich ten did so significantly (P\0.01). There was a significant drop in the mean serum calcium (preop. 11.1 mg/dl, postop. 9.6 mg/dl; P\0.0001) and PTH (preop. 130.9 pg/ml, postop. 45.7 pg/ml;P\0.0001) at longterm follow-up. Five patients (2.5%) developed recurrent disease (calcium[10.5 mg/dl), and one (0.5%) underwent a reoperation for persistent disease andwas subsequently cured. Conclusions This study demonstrates that MIP has longterm benefits in terms of excellent symptom resolution and a high biochemical cure rate (97%) in selected patients who have PHPT, preoperative localization with sestamibi scans, and assessment of intraoperative PTH level.

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