Worldwide Trends in the Surgical Treatment of Primary Hyperparathyroidism in the Era of Minimally Invasive Parathyroidectomy
- 1 September 2002
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Surgery
- Vol. 137 (9), 1055-9
- https://doi.org/10.1001/archsurg.137.9.1055
Abstract
Minimally invasive surgery for primary hyperparathyroidism has become an accepted part of endocrine surgical practice worldwide. Survey of members of the International Association of Endocrine Surgeons. Clinical practice of endocrine surgeons worldwide. Numbers of parathyroid procedures performed, types of minimally invasive procedures undertaken, and techniques used to ensure completeness of removal of hyperfunctioning parathyroid tissue as reported by the survey respondents. Of 160 surveys completed, 95 (59%) indicate that the surgeons currently perform minimally invasive parathyroidectomy and use this technique on average for 44% of patients with primary hyperparathyroidism. The most common approach is the focused technique with a small incision, either central or lateral (92% [87 respondents]), followed by a video-assisted technique (22% [21 respondents]), and a true endoscopic technique with gas insufflation (12% [11 respondents]). Techniques used to ensure completeness of resection include the quick intraoperative intact parathyroid hormone assay (68% [65 respondents]), a same-day intact parathyroid hormone assay (17% [16 respondents]), and the nuclear probe (14% [13 respondents]). The number of parathyroidectomies performed worldwide increased from 1727 in 1980 to 6977 in 2000 with the average number per surgeon increasing from 23 in 1980 to 45 in 2000. Geographically, 20 (59%) of 34 surveys from the Americas report the use of minimally invasive parathyroidectomy, 23 (56%) of 41 from the Australasian region, and 34 (49%) of 69 from Europe or the Middle East. The number of parathyroidectomies performed for primary hyperparathyroidism has increased worldwide over the past 20 years. More than half of the surgeons responding to the survey perform minimally invasive parathyroidectomy, with the most using the focused small-incision technique.Keywords
This publication has 20 references indexed in Scilit:
- Endothelial dysfunction in endocrine diseaseTrends in Endocrinology & Metabolism, 2001
- Impaired vascular reactivity in primary hyperparathyroidism may contribute to cardiovascular riskClinical Endocrinology, 2001
- Randomized trial of parathyroidectomy in mild asymptomatic primary hyperparathyroidism: Patient description and effects on the SF-36 health surveySurgery, 2000
- NATURAL HISTORY OF PRIMARY HYPERPARATHYROIDISMEndocrinology and Metabolism Clinics of North America, 2000
- A 10-Year Prospective Study of Primary Hyperparathyroidism with or without Parathyroid SurgeryThe New England Journal of Medicine, 1999
- Insulin secretion, insulin sensitivity and hepatic insulin extraction in primary hyperparathyroidism before and after surgeryClinical Endocrinology, 1992
- Journal of Bone and Mineral ResearchJournal of Bone and Mineral Research, 1991
- Evaluation of glucose tolerance, insulin secretion, and insulin action in patients with primary hyperparathyroidism before and after surgeryCalcified Tissue International, 1990
- Asymptomatic hyperparathyroidism: An assessment of operative interventionBritish Journal of Surgery, 1980
- Metabolic Effects of Parathyroidectomy in Asymptomatic Primary HyperparathyroidismJournal of Clinical Endocrinology & Metabolism, 1976