Abstract
This is a review of the latest papers on PHPT with the purpose of assessing the most recent evidence in the management of PHPT and to give updated recommendations for its evaluation, diagnosis, and treatment. I used my personal experience to collect papers that reinforce my ideas for the diagnosis and treatment of PHPT. Perhaps, in the near future, we will have more information about genetics, localization studies, surgical techniques, medical treatments, and statements that we have presented today will be obsolete.
Similar content being viewed by others
Abbreviations
- PHPT:
-
Primary hyperparathyroidism
- PTH:
-
Parathyroid hormone
- IOPTH:
-
Intraoperative PTH
- PTx:
-
Parathyroidectomy
- MGD:
-
Multiglandular disease
- MIP:
-
Mininvasive procedure
- BNE:
-
Bilateral neck exploration
References
Shindo M, Lee JA, Lubitz CC, McCoy KL, Orloff LA, Tufano RP, Pasieka JL (2016) The changing landscape of primary, secondary, and tertiary hyperparathyroidism: highlights from the american college of surgeons panel, “what’s new for the surgeon caring for patients with hyperparathyroidism. J Am Coll Surg 222:1241–1250
Wilhelm SM, Wang TS, Ruan DT, Lee JA, Asa SL, Duh QY, Doherty GM, Herrera MF, Pasieka JL, Perrier ND, Silverberg SJ, Solórzano CC, Sturgeon C, Tublin ME, Udelsman R, Carty SE (2016) The American association of endocrine surgeons guidelines for definitive management of primary hyperparathyroidism. JAMA Surg 151:959–968
Liu JY, Saunders ND, Chen A, Weber CJ, Sharma J (2016) Neuropsychological changes in primary hyperparathyroidism after parathyroidectomy. Am Surg 82:839–845
Pasieka JL, Parsons L, Jones J (2009) The long-term benefit of parathyroidectomy in primary hyperparathyroidism: a 10-year prospective surgical outcome study. Surgery 146:1006–1013
Pasieka JL, Parsons LL (1998) Prospective surgical outcome study of relief of symptoms following surgery in patients with primary hyperparathyroidism. World J Surg 22:513–518
Sheldon DG, Lee FT, Neil NJ, Ryan JA Jr (2002) Surgical treatment of hyperparathyroidism improves health-related quality of life. Arch Surg 137:1022–1026
Ambrogini E, Cetani F, Cianferotti L, Vignali E, Banti C, Viccica G, Oppo A, Miccoli P, Berti P, Bilezikian JP, Pinchera A, Marcocci C (2007) Surgery or surveillance formild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial. J Clin Endocrinol Metab 92:3114–3121
Zanocco K, Angelos P, Sturgeon C (2006) Cost-effectiveness analysis of parathyroidectomy for asymptomatic primary hyperparathyroidism. Surgery 140:874–881
Khan AA, Hanley DA, Rizzoli R, Bollerslev J, Young JE, Rejnmark L, Thakker R, D’Amour P, Paul T, Van Uum S, Shrayyef MZ, Goltzman D, Kaiser S, Cusano NE, Bouillon R, Mosekilde L, Kung AW, Rao SD, Bhadada SK, Clarke BL, Liu J, Duh Q, Lewiecki EM, Bandeira F, Eastell R, Marcocci C, Silverberg SJ, Udelsman R, Davison KS, Potts JT Jr, Brandi ML, Bilezikian JP (2017) Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int 28:1–19
Kluijfhout W, Pasternak JD, Drake F, Beninato T, Gosnell JE, Shen WT, Duh QY, Allen IE, Vriens MR, de Keizer B, Pampaloni MH, Suh I (2016) Use of PET tracers for parathyroid localization: a systematic review and meta-analysis. Langenbecks Arch Surg 401:925–935
Fortuny JV, Karenovics W, Triponez F, Sadowski SM (2016) Intra-operative indocyanine green angiography of the parathyroid gland. World J Surg 40:2378–2381
Fortuny JV, Belfontali V, Sadowski SM, Karenovics W, Guigard S, Triponez F (2016) Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery. BJS 103:537–543
Gasparri G, Palestini N, Freddi M, Sisto G, Camandona M (2015) Parathyroid exploration for primary hyperparathyroidism. In: Gasparri G et al (eds) Springer, Italia, pp 117–32
De Gregorio L, Lubitz CC, Hodin RA, Gaz RD, Parangi S, Phitayakorn R, Stephen AE (2016) The truth about double adenomas: incidence, localization, and intraoperative parathyroid hormone. J Am Coll Surg 222:1044–1052
Mengozzi G (2016) Clinical use of the parathyroid hormone assay. In: Gasparri G et al (eds). Springer, Italia, pp 29–40
Kiernan CM, Schlegel C, Isom C, Kavalukas S, Peters MF, Solórzano CC (2016) Ambulatory bilateral neck exploration forprimary hyperparathyroidism: is it safe? Am J Surg 212:722–727
Siperstein A, Berber E, Barbosa GF, Tsinberg M, Greene AB, Mitchell J, Milas M (2008) Predicting the success of limited exploration for primary hyperparathyroidism using ultrasound, sestamibi, and intraoperative parathyroid hormone: analysis of 1158 cases. Ann Surg 248:420–428
Norman J, Lopez J, Politz D (2012) Abandoning unilateral parathyroidectomy: why we reversed our position after 15,000 parathyroid operations. J Am Coll Surg 214:260–269
Thier M, Nordenström E, Almquist M, Bergenfelz A (2016) Results of a fifteen-year follow-up program in patients operated with unilateral neck exploration for primary hyperparathyroidism. World J Surg 40:582–588
Rio PD, Vicente D, Maestroni U, Totaro A, Pattacini GM, Avital I, Stojadinovic A, Sianesi M (2013) A comparison of minimally invasive video-assisted parathyroidectomy and traditional parathyroidectomy for parathyroid adenoma. J Cancer 4:458–463
Wong W, Foo FJ, Lau MI, Sarin A, Kiruparan P (2011) Simplified minimally invasive parathyroidectomy: a series of 100 cases and review of the literature. Ann R Coll Surg Engl 93:290–293
Garas G, Holsinger FC, Grant DG, Athanasiou T, Arora A, Tolley N (2015) Is robotic parathyroidectomy a feasible and safe alternative to targeted open parathyroidectomy for the treatment of primary hyperparathyroidism? Int J Surg 15:55–60
Tolley N, Garas G, Palazzo F, Prichard A, Chaidas K, Cox J, Darzi A, Arora A (2016) Long-term prospective evaluation comparing robotic parathyroidectomy with minimally invasive open parathyroidectomy for primary hyperparathyroidism. Head Neck 38:300–306
Kang J, Fan Y, Guo B, Wu B, Zheng Q (2013) Trans-areola single-site endoscopic parathyroidectomy: report of one case. Surg Innov. 20:16–20
Brunaud L, Zhen L, Van Den Heede K, Cuny T, Van-Slycke S (2016) Endoscopic and robotic parathyroidectomy in patients with primary hyperparathyroidism. Gland Surg. 5:352–360
Javid M, Callender G, Quinn C, Carling T, Donovan P, Udelsman R (2017) Primary hyperparathyroidism with normal baseline intraoperative parathyroid hormone: a challenging population. Surgery 161:493–498
Sosa JA (2016) How best to approach surgery for primary hyperparathyroidism—canwe all agree? JAMA Surg 151:969
Nordenström J (2013) The hunt for the parathyroids. Wiley, Chichester
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The author declares that he has no conflict of interest.
Ethical approval
For this type of study formal consent is not required.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Gasparri, G. Updates in primary hyperparathyroidism. Updates Surg 69, 217–223 (2017). https://doi.org/10.1007/s13304-017-0477-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-017-0477-1