Reoperative parathyroid surgery for persistent hyperparathyroidism

M. F. Brennan, J. L. Doppman, S. J. Marx, Allen M. Spiegel, E. M. Brown, G. D. Aurbach

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56%, and retrospectively was correct in 63%. Selective venous catheterization gave localizing information in 83%, correctly predicting site or side in 60% of the total. Computerized axial tomography was helpful in identifying mediastinal glands before operation. Reoperation was successful in rendering the patient hypocalcemic or normacalcemic in 83%. Of the 11 patients (37%) who were rendered profoundly hypocalcemic, two were subsequently weaned from vitamin D and calcium support; seven have received either fresh or cryopreserved parathyroid autografts. Persistent hyperparathyroidism is a difficult surgical problem which we believe warrants aggressive localization attempts prior to operation. Autotransplantation with cryopreserved parathyroid tissue may be of value in the long-term management of the high incidence of postoperative hypocalcemia in this patient group.

Original languageEnglish (US)
Pages (from-to)669-676
Number of pages8
JournalSurgery
Volume83
Issue number6
StatePublished - 1978
Externally publishedYes

Fingerprint

Hyperparathyroidism
Reoperation
Hypocalcemia
Autologous Transplantation
Autografts
Vitamin D
Catheterization
Angiography
Tomography
Calcium
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Brennan, M. F., Doppman, J. L., Marx, S. J., Spiegel, A. M., Brown, E. M., & Aurbach, G. D. (1978). Reoperative parathyroid surgery for persistent hyperparathyroidism. Surgery, 83(6), 669-676.

Reoperative parathyroid surgery for persistent hyperparathyroidism. / Brennan, M. F.; Doppman, J. L.; Marx, S. J.; Spiegel, Allen M.; Brown, E. M.; Aurbach, G. D.

In: Surgery, Vol. 83, No. 6, 1978, p. 669-676.

Research output: Contribution to journalArticle

Brennan, MF, Doppman, JL, Marx, SJ, Spiegel, AM, Brown, EM & Aurbach, GD 1978, 'Reoperative parathyroid surgery for persistent hyperparathyroidism', Surgery, vol. 83, no. 6, pp. 669-676.
Brennan MF, Doppman JL, Marx SJ, Spiegel AM, Brown EM, Aurbach GD. Reoperative parathyroid surgery for persistent hyperparathyroidism. Surgery. 1978;83(6):669-676.
Brennan, M. F. ; Doppman, J. L. ; Marx, S. J. ; Spiegel, Allen M. ; Brown, E. M. ; Aurbach, G. D. / Reoperative parathyroid surgery for persistent hyperparathyroidism. In: Surgery. 1978 ; Vol. 83, No. 6. pp. 669-676.
@article{74e8a29c1b3f4d8488625e861dc9de39,
title = "Reoperative parathyroid surgery for persistent hyperparathyroidism",
abstract = "In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56{\%}, and retrospectively was correct in 63{\%}. Selective venous catheterization gave localizing information in 83{\%}, correctly predicting site or side in 60{\%} of the total. Computerized axial tomography was helpful in identifying mediastinal glands before operation. Reoperation was successful in rendering the patient hypocalcemic or normacalcemic in 83{\%}. Of the 11 patients (37{\%}) who were rendered profoundly hypocalcemic, two were subsequently weaned from vitamin D and calcium support; seven have received either fresh or cryopreserved parathyroid autografts. Persistent hyperparathyroidism is a difficult surgical problem which we believe warrants aggressive localization attempts prior to operation. Autotransplantation with cryopreserved parathyroid tissue may be of value in the long-term management of the high incidence of postoperative hypocalcemia in this patient group.",
author = "Brennan, {M. F.} and Doppman, {J. L.} and Marx, {S. J.} and Spiegel, {Allen M.} and Brown, {E. M.} and Aurbach, {G. D.}",
year = "1978",
language = "English (US)",
volume = "83",
pages = "669--676",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Reoperative parathyroid surgery for persistent hyperparathyroidism

AU - Brennan, M. F.

AU - Doppman, J. L.

AU - Marx, S. J.

AU - Spiegel, Allen M.

AU - Brown, E. M.

AU - Aurbach, G. D.

PY - 1978

Y1 - 1978

N2 - In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56%, and retrospectively was correct in 63%. Selective venous catheterization gave localizing information in 83%, correctly predicting site or side in 60% of the total. Computerized axial tomography was helpful in identifying mediastinal glands before operation. Reoperation was successful in rendering the patient hypocalcemic or normacalcemic in 83%. Of the 11 patients (37%) who were rendered profoundly hypocalcemic, two were subsequently weaned from vitamin D and calcium support; seven have received either fresh or cryopreserved parathyroid autografts. Persistent hyperparathyroidism is a difficult surgical problem which we believe warrants aggressive localization attempts prior to operation. Autotransplantation with cryopreserved parathyroid tissue may be of value in the long-term management of the high incidence of postoperative hypocalcemia in this patient group.

AB - In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56%, and retrospectively was correct in 63%. Selective venous catheterization gave localizing information in 83%, correctly predicting site or side in 60% of the total. Computerized axial tomography was helpful in identifying mediastinal glands before operation. Reoperation was successful in rendering the patient hypocalcemic or normacalcemic in 83%. Of the 11 patients (37%) who were rendered profoundly hypocalcemic, two were subsequently weaned from vitamin D and calcium support; seven have received either fresh or cryopreserved parathyroid autografts. Persistent hyperparathyroidism is a difficult surgical problem which we believe warrants aggressive localization attempts prior to operation. Autotransplantation with cryopreserved parathyroid tissue may be of value in the long-term management of the high incidence of postoperative hypocalcemia in this patient group.

UR - http://www.scopus.com/inward/record.url?scp=0018096777&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0018096777&partnerID=8YFLogxK

M3 - Article

C2 - 644460

AN - SCOPUS:0018096777

VL - 83

SP - 669

EP - 676

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 6

ER -