Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?

Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be u...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Mortier, Pierre-E. [verfasserIn] Mozzon, Marta M. Fouquet, Olivier P. Soudan, Benoit C. Huglo, Damien G. Cussac, Jean-F. Proye, Charles A.G.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2004

Schlagwörter:	Bilateral Neck Exploration Enlarge Gland Multiglandular Disease Unilateral Approach Unilateral Neck Exploration

Anmerkung:	© Société Internationale de Chirurgie 2004

Übergeordnetes Werk:	Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 28(2004), 12 vom: 11. Nov., Seite 1298-1304
Übergeordnetes Werk:	volume:28 ; year:2004 ; number:12 ; day:11 ; month:11 ; pages:1298-1304

Links:	Volltext

DOI / URN:	10.1007/s00268-004-7468-3

Katalog-ID:	SPR003400379

Internformat


LEADER	01000caa a22002652 4500
001	SPR003400379
003	DE-627
005	20230520010244.0
007	cr uuu---uuuuu
008	201001s2004 xx \|\|\|\|\|o 00\| \|\|eng c
024	7		\|a 10.1007/s00268-004-7468-3 \|2 doi
035			\|a (DE-627)SPR003400379
035			\|a (SPR)s00268-004-7468-3-e
040			\|a DE-627 \|b ger \|c DE-627 \|e rakwb
041			\|a eng
100	1		\|a Mortier, Pierre-E. \|e verfasserin \|4 aut
245	1	0	\|a Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?
264		1	\|c 2004
336			\|a Text \|b txt \|2 rdacontent
337			\|a Computermedien \|b c \|2 rdamedia
338			\|a Online-Ressource \|b cr \|2 rdacarrier
500			\|a © Société Internationale de Chirurgie 2004
520			\|a Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified.
650		4	\|a Bilateral Neck Exploration \|7 (dpeaa)DE-He213
650		4	\|a Enlarge Gland \|7 (dpeaa)DE-He213
650		4	\|a Multiglandular Disease \|7 (dpeaa)DE-He213
650		4	\|a Unilateral Approach \|7 (dpeaa)DE-He213
650		4	\|a Unilateral Neck Exploration \|7 (dpeaa)DE-He213
700	1		\|a Mozzon, Marta M. \|4 aut
700	1		\|a Fouquet, Olivier P. \|4 aut
700	1		\|a Soudan, Benoit C. \|4 aut
700	1		\|a Huglo, Damien G. \|4 aut
700	1		\|a Cussac, Jean-F. \|4 aut
700	1		\|a Proye, Charles A.G. \|4 aut
773	0	8	\|i Enthalten in \|t World Journal of Surgery \|d Springer-Verlag, 1996 \|g 28(2004), 12 vom: 11. Nov., Seite 1298-1304 \|w (DE-627)SPR003391159 \|7 nnns
773	1	8	\|g volume:28 \|g year:2004 \|g number:12 \|g day:11 \|g month:11 \|g pages:1298-1304
856	4	0	\|u https://dx.doi.org/10.1007/s00268-004-7468-3 \|z lizenzpflichtig \|3 Volltext
912			\|a GBV_USEFLAG_A
912			\|a SYSFLAG_A
912			\|a GBV_SPRINGER
912			\|a SSG-OLC-PHA
951			\|a AR
952			\|d 28 \|j 2004 \|e 12 \|b 11 \|c 11 \|h 1298-1304

Indexfelder

author_variant	p e m pem m m m mm mmm o p f op opf b c s bc bcs d g h dg dgh j f c jfc c a p ca cap
matchkey_str	mortierpierreemozzonmartamfouquetolivier:2004----:nltrlugrfryeprtyodsidctosiisnltrslsepioohoepnieeeto
hierarchy_sort_str	2004
publishDate	2004
allfields	10.1007/s00268-004-7468-3 doi (DE-627)SPR003400379 (SPR)s00268-004-7468-3-e DE-627 ger DE-627 rakwb eng Mortier, Pierre-E. verfasserin aut Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results? 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2004 Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. Bilateral Neck Exploration (dpeaa)DE-He213 Enlarge Gland (dpeaa)DE-He213 Multiglandular Disease (dpeaa)DE-He213 Unilateral Approach (dpeaa)DE-He213 Unilateral Neck Exploration (dpeaa)DE-He213 Mozzon, Marta M. aut Fouquet, Olivier P. aut Soudan, Benoit C. aut Huglo, Damien G. aut Cussac, Jean-F. aut Proye, Charles A.G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 28(2004), 12 vom: 11. Nov., Seite 1298-1304 (DE-627)SPR003391159 nnns volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304 https://dx.doi.org/10.1007/s00268-004-7468-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 28 2004 12 11 11 1298-1304
spelling	10.1007/s00268-004-7468-3 doi (DE-627)SPR003400379 (SPR)s00268-004-7468-3-e DE-627 ger DE-627 rakwb eng Mortier, Pierre-E. verfasserin aut Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results? 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2004 Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. Bilateral Neck Exploration (dpeaa)DE-He213 Enlarge Gland (dpeaa)DE-He213 Multiglandular Disease (dpeaa)DE-He213 Unilateral Approach (dpeaa)DE-He213 Unilateral Neck Exploration (dpeaa)DE-He213 Mozzon, Marta M. aut Fouquet, Olivier P. aut Soudan, Benoit C. aut Huglo, Damien G. aut Cussac, Jean-F. aut Proye, Charles A.G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 28(2004), 12 vom: 11. Nov., Seite 1298-1304 (DE-627)SPR003391159 nnns volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304 https://dx.doi.org/10.1007/s00268-004-7468-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 28 2004 12 11 11 1298-1304
allfields_unstemmed	10.1007/s00268-004-7468-3 doi (DE-627)SPR003400379 (SPR)s00268-004-7468-3-e DE-627 ger DE-627 rakwb eng Mortier, Pierre-E. verfasserin aut Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results? 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2004 Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. Bilateral Neck Exploration (dpeaa)DE-He213 Enlarge Gland (dpeaa)DE-He213 Multiglandular Disease (dpeaa)DE-He213 Unilateral Approach (dpeaa)DE-He213 Unilateral Neck Exploration (dpeaa)DE-He213 Mozzon, Marta M. aut Fouquet, Olivier P. aut Soudan, Benoit C. aut Huglo, Damien G. aut Cussac, Jean-F. aut Proye, Charles A.G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 28(2004), 12 vom: 11. Nov., Seite 1298-1304 (DE-627)SPR003391159 nnns volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304 https://dx.doi.org/10.1007/s00268-004-7468-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 28 2004 12 11 11 1298-1304
allfieldsGer	10.1007/s00268-004-7468-3 doi (DE-627)SPR003400379 (SPR)s00268-004-7468-3-e DE-627 ger DE-627 rakwb eng Mortier, Pierre-E. verfasserin aut Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results? 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2004 Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. Bilateral Neck Exploration (dpeaa)DE-He213 Enlarge Gland (dpeaa)DE-He213 Multiglandular Disease (dpeaa)DE-He213 Unilateral Approach (dpeaa)DE-He213 Unilateral Neck Exploration (dpeaa)DE-He213 Mozzon, Marta M. aut Fouquet, Olivier P. aut Soudan, Benoit C. aut Huglo, Damien G. aut Cussac, Jean-F. aut Proye, Charles A.G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 28(2004), 12 vom: 11. Nov., Seite 1298-1304 (DE-627)SPR003391159 nnns volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304 https://dx.doi.org/10.1007/s00268-004-7468-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 28 2004 12 11 11 1298-1304
allfieldsSound	10.1007/s00268-004-7468-3 doi (DE-627)SPR003400379 (SPR)s00268-004-7468-3-e DE-627 ger DE-627 rakwb eng Mortier, Pierre-E. verfasserin aut Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results? 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2004 Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. Bilateral Neck Exploration (dpeaa)DE-He213 Enlarge Gland (dpeaa)DE-He213 Multiglandular Disease (dpeaa)DE-He213 Unilateral Approach (dpeaa)DE-He213 Unilateral Neck Exploration (dpeaa)DE-He213 Mozzon, Marta M. aut Fouquet, Olivier P. aut Soudan, Benoit C. aut Huglo, Damien G. aut Cussac, Jean-F. aut Proye, Charles A.G. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 28(2004), 12 vom: 11. Nov., Seite 1298-1304 (DE-627)SPR003391159 nnns volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304 https://dx.doi.org/10.1007/s00268-004-7468-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 28 2004 12 11 11 1298-1304
language	English
source	Enthalten in World Journal of Surgery 28(2004), 12 vom: 11. Nov., Seite 1298-1304 volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304
sourceStr	Enthalten in World Journal of Surgery 28(2004), 12 vom: 11. Nov., Seite 1298-1304 volume:28 year:2004 number:12 day:11 month:11 pages:1298-1304
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Bilateral Neck Exploration Enlarge Gland Multiglandular Disease Unilateral Approach Unilateral Neck Exploration
isfreeaccess_bool	false
container_title	World Journal of Surgery
authorswithroles_txt_mv	Mortier, Pierre-E. @@aut@@ Mozzon, Marta M. @@aut@@ Fouquet, Olivier P. @@aut@@ Soudan, Benoit C. @@aut@@ Huglo, Damien G. @@aut@@ Cussac, Jean-F. @@aut@@ Proye, Charles A.G. @@aut@@
publishDateDaySort_date	2004-11-11T00:00:00Z
hierarchy_top_id	SPR003391159
id	SPR003400379
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR003400379</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230520010244.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201001s2004 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s00268-004-7468-3</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR003400379</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s00268-004-7468-3-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Mortier, Pierre-E.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2004</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© Société Internationale de Chirurgie 2004</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Bilateral Neck Exploration</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Enlarge Gland</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Multiglandular Disease</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Unilateral Approach</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Unilateral Neck Exploration</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Mozzon, Marta M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Fouquet, Olivier P.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Soudan, Benoit C.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Huglo, Damien G.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cussac, Jean-F.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Proye, Charles A.G.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">World Journal of Surgery</subfield><subfield code="d">Springer-Verlag, 1996</subfield><subfield code="g">28(2004), 12 vom: 11. Nov., Seite 1298-1304</subfield><subfield code="w">(DE-627)SPR003391159</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:28</subfield><subfield code="g">year:2004</subfield><subfield code="g">number:12</subfield><subfield code="g">day:11</subfield><subfield code="g">month:11</subfield><subfield code="g">pages:1298-1304</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://dx.doi.org/10.1007/s00268-004-7468-3</subfield><subfield code="z">lizenzpflichtig</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_SPRINGER</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">28</subfield><subfield code="j">2004</subfield><subfield code="e">12</subfield><subfield code="b">11</subfield><subfield code="c">11</subfield><subfield code="h">1298-1304</subfield></datafield></record></collection>
author	Mortier, Pierre-E.
spellingShingle	Mortier, Pierre-E. misc Bilateral Neck Exploration misc Enlarge Gland misc Multiglandular Disease misc Unilateral Approach misc Unilateral Neck Exploration Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?
authorStr	Mortier, Pierre-E.
ppnlink_with_tag_str_mv	@@773@@(DE-627)SPR003391159
format	electronic Article
delete_txt_mv	keep
author_role	aut aut aut aut aut aut aut
collection	springer
remote_str	true
illustrated	Not Illustrated
topic_title	Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results? Bilateral Neck Exploration (dpeaa)DE-He213 Enlarge Gland (dpeaa)DE-He213 Multiglandular Disease (dpeaa)DE-He213 Unilateral Approach (dpeaa)DE-He213 Unilateral Neck Exploration (dpeaa)DE-He213
topic	misc Bilateral Neck Exploration misc Enlarge Gland misc Multiglandular Disease misc Unilateral Approach misc Unilateral Neck Exploration
topic_unstemmed	misc Bilateral Neck Exploration misc Enlarge Gland misc Multiglandular Disease misc Unilateral Approach misc Unilateral Neck Exploration
topic_browse	misc Bilateral Neck Exploration misc Enlarge Gland misc Multiglandular Disease misc Unilateral Approach misc Unilateral Neck Exploration
format_facet	Elektronische Aufsätze Aufsätze Elektronische Ressource
format_main_str_mv	Text Zeitschrift/Artikel
carriertype_str_mv	cr
hierarchy_parent_title	World Journal of Surgery
hierarchy_parent_id	SPR003391159
hierarchy_top_title	World Journal of Surgery
isfreeaccess_txt	false
familylinks_str_mv	(DE-627)SPR003391159
title	Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?
ctrlnum	(DE-627)SPR003400379 (SPR)s00268-004-7468-3-e
title_full	Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?
author_sort	Mortier, Pierre-E.
journal	World Journal of Surgery
journalStr	World Journal of Surgery
lang_code	eng
isOA_bool	false
recordtype	marc
publishDateSort	2004
contenttype_str_mv	txt
container_start_page	1298
author_browse	Mortier, Pierre-E. Mozzon, Marta M. Fouquet, Olivier P. Soudan, Benoit C. Huglo, Damien G. Cussac, Jean-F. Proye, Charles A.G.
container_volume	28
format_se	Elektronische Aufsätze
author-letter	Mortier, Pierre-E.
doi_str_mv	10.1007/s00268-004-7468-3
title_sort	unilateral surgery for hyperparathyroidism: indications, limits, and late results—new philosophy or expensive selection without improvement of surgical results?
title_auth	Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?
abstract	Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. © Société Internationale de Chirurgie 2004
abstractGer	Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. © Société Internationale de Chirurgie 2004
abstract_unstemmed	Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified. © Société Internationale de Chirurgie 2004
collection_details	GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA
container_issue	12
title_short	Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?
url	https://dx.doi.org/10.1007/s00268-004-7468-3
remote_bool	true
author2	Mozzon, Marta M. Fouquet, Olivier P. Soudan, Benoit C. Huglo, Damien G. Cussac, Jean-F. Proye, Charles A.G.
author2Str	Mozzon, Marta M. Fouquet, Olivier P. Soudan, Benoit C. Huglo, Damien G. Cussac, Jean-F. Proye, Charles A.G.
ppnlink	SPR003391159
mediatype_str_mv	c
isOA_txt	false
hochschulschrift_bool	false
doi_str	10.1007/s00268-004-7468-3
up_date	2024-07-03T19:19:16.318Z
_version_	1803586745212600320
fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR003400379</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230520010244.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201001s2004 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s00268-004-7468-3</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR003400379</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s00268-004-7468-3-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Mortier, Pierre-E.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2004</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© Société Internationale de Chirurgie 2004</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract We assessed the “late” results after unilateral parathyroidectomy (PTX) performed for selected indications. From October 1998 throughout March 2001 we operated on 454 patients for hyperparathyroidism (HPT). A positive unifocal 99mtc-MIBI scan was required for the unilateral approach to be used. Intact parathormone (PTH) measurements were done intraoperatively. Postoperative calcium and PTH serum levels of unilaterally operated patients were checked. Follow-up has been 16.2 months (range 6–40 months). Of the 454 patients, 336 (74.0%) were not eligible for the unilateral approach; and 125 (27.5%) of the 454 patients had renal HPT. Among the 329 patients with primary HPT, 125 (38.0%) were excluded for well established reasons, and in 77 other cases (23.5%) preoperative imaging results did not allow the unilateral approach. Altogether, 126 patients (38.3%) with primary HPT were selected for the unilateral approach. Of the 126 unilateral operations, 8 (6.3%) had to be converted to a bilateral procedure. Among the 118 patients with a unilateral approach, 3 patients have been reoperated for overlooked contralateral disease, and 13 dropped out of the study. A total of 102 postoperative calcium and PTH serum late levels are known: 90 (88.2%) patients had normal levels; 10 (9.8%) had a high PTH level, and 2 (1.9%) had high ionized calcium levels. The failure rate in selected cases was 4.2% (5/118) (three were reoperated, and two had a supranormal postoperative ionized Ca level). Even with stringent indications, the late results of unilateral surgery (95.8% cure rate) barely matched those of conventional bilateral surgery (97.6% cure rate). The economic impact of such a surgical strategy should be clarified.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Bilateral Neck Exploration</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Enlarge Gland</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Multiglandular Disease</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Unilateral Approach</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Unilateral Neck Exploration</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Mozzon, Marta M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Fouquet, Olivier P.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Soudan, Benoit C.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Huglo, Damien G.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cussac, Jean-F.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Proye, Charles A.G.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">World Journal of Surgery</subfield><subfield code="d">Springer-Verlag, 1996</subfield><subfield code="g">28(2004), 12 vom: 11. Nov., Seite 1298-1304</subfield><subfield code="w">(DE-627)SPR003391159</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:28</subfield><subfield code="g">year:2004</subfield><subfield code="g">number:12</subfield><subfield code="g">day:11</subfield><subfield code="g">month:11</subfield><subfield code="g">pages:1298-1304</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://dx.doi.org/10.1007/s00268-004-7468-3</subfield><subfield code="z">lizenzpflichtig</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_SPRINGER</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">28</subfield><subfield code="j">2004</subfield><subfield code="e">12</subfield><subfield code="b">11</subfield><subfield code="c">11</subfield><subfield code="h">1298-1304</subfield></datafield></record></collection>
score	7.3995686

Nicht das Richtige dabei?

Schreiben Sie uns!

Unilateral Surgery for Hyperparathyroidism: Indications, Limits, and Late Results—New Philosophy or Expensive Selection without Improvement of Surgical Results?

Nicht das Richtige dabei?

Zugang & Verfügbarkeit

Vorhandene Bände

Nicht das Richtige dabei?