 |
|
The Reasons for Failure in Parathyroid Operations
Kenneth E. Levin, MD;
Orlo H. Clark, MD
Arch Surg. 1989;124(8):911-915.
Abstract
| |
• Primary hyperparathyroidism occurs in about 1 in every 700 individuals. We analyzed our experience with 81 patients with persistent or recurrent hyperparathyroidism who were treated at the University of California, San Francisco, and the Veterans Administration Medical Center, San Francisco, from January 1979 through September 1988. In the 89 reoperations performed, the following six reasons or combination of reasons were responsible for the failed initial operation: (1) in 50 patients, there were multiple abnormal glands (30 hyperplastic and 20 second adenoma); (2) in 40 patients, the tumor was located in an ectopic position (22 mediastinal, 9 deep-seated cervical, 7 intrathyroidal, and 2 undescended); (3) in 17 patients, there were supernumerary parathyroid glands; (4) in 12 patients, the abnormal parathyroid glands were found in normal locations and the tumors were missed because of surgeon inexperience; (5) in 4 patients, failure was due to metastatic parathyroid cancer; and (6) in 4 patients, failure was due to errors on frozen section examinations. Preoperative localization studies usually identified the abnormal parathyroid tumor(s) prior to reoperations and were helpful in these patients. Knowledge of the reasons for failed parathyroid operations and the usual and unusual sites where parathyroid tumors are situated as well as a complete exploration should decrease the frequency of failed parathyroid operations. Localization studies are helpful for identifying these often elusive tumors.
(Arch Surg. 1989;124:911-915)
Author Affiliations
From the Veterans Administration Medical Center (112), San Francisco, Calif.
Footnotes
Accepted for publication April 3, 1989.
Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 15, 1988.
Reprint requests to Veterans Administration Medical Center (112), 4150 Clement St, San Francisco, CA 94121 (Dr Clark).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Parathyroid Hormone Venous Sampling Before Reoperative Surgery in Renal Hyperparathyroidism: Comparison With Noninvasive Localization Procedures and Review of the Literature
Seehofer et al.
Arch Surg 2004;139:1331-1338.
ABSTRACT
| FULL TEXT
Evaluation of the Performance and Clinical Impact of a Rapid Intraoperative Parathyroid Hormone Assay in Conjunction with Preoperative Imaging and Concise Parathyroidectomy
Johnson et al.
Clin. Chem. 2001;47:919-925.
ABSTRACT
| FULL TEXT
Use of Intraoperative Parathyroid Hormone Measurement Does Not Improve Success of Bilateral Neck Exploration for Hyperparathyroidism
Starr et al.
Arch Surg 2001;136:536-542.
ABSTRACT
| FULL TEXT
Comparison between MR Imaging and
Gotway et al.
Radiology 2001;218:783-790.
ABSTRACT
| FULL TEXT
Minimally Invasive Surgery for Primary Hyperparathyroidism: Systematic Review
Reeve et al.
Arch Surg 2000;135:481-487.
ABSTRACT
| FULL TEXT
Reoperation for Persistent or Recurrent Primary Hyperparathyroidism
Shen et al.
Arch Surg 1996;131:861-869.
ABSTRACT
Thoracoscopic Removal of Mediastinal Parathyroid Adenoma
Smythe et al.
Ann. Thorac. Surg. 1995;59:236-238.
ABSTRACT
| FULL TEXT
Parathyroid Adenoma Associated With a Branchial Cleft Cyst
Redleaf et al.
Arch Otolaryngol Head Neck Surg 1995;121:113-115.
ABSTRACT
Localization Procedures in Patients With Persistent or Recurrent Hyperparathyroidism
Rodriquez et al.
Arch Surg 1994;129:870-875.
ABSTRACT
Reexploration and Angiographic Ablation for Hyperparathyroidism
McIntyre et al.
Arch Surg 1994;129:499-505.
ABSTRACT
Unilateral Neck Exploration for Primary Hyperparathyroidism
Lucas et al.
Arch Surg 1990;125:982-985.
ABSTRACT
|
