Current trends in the surgical treatment of solitary parathyroid adenoma. A questionnaire study from 53 surgical departments in 14 countries.
Current trends in the surgical treatment of primary hyperparathyroidism due to solitary parathyroid adenoma were evaluated in a questionnaire study. Response was obtained from 53 departments highly active in endocrine surgery in 14 countries (response rate 95%). Intraoperative histologic examination is widely (70%) regarded as necessary, but utilized more in North America and Scandinavia (87%) than elsewhere (45%). Intraoperative fat staining is used in one-third of the departments. Excisional biopsy including one whole gland is preferred by 32% to multiple incisional biopsies. Gross inspection of three normal parathyroid glands without histologic identification is favoured in 21% of the departments, while 31% prefer bilateral exploration and incisional biopsy. When an adenoma is found on the first side to be explored, 17% advocate bilateral exploration with incisional biopsy of all three normal glands, whereas unilateral exploration with excisional or incisional biopsy of the ipsilateral normal gland is preferred by a similar percentage.
Tibblin
S
S
Department of Surgery, University of Kuwait, Kuwait.
Bondesson
A G
AG
Udén
P
P
D000236:Adenoma / Q000601:surgery*; D002985:Clinical Protocols; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery; D009656:North America; D010282:Parathyroid Neoplasms / Q000601:surgery*; D012537:Scandinavian and Nordic Countries; D013503:Surgery Department, Hospital; D011795:Surveys and Questionnaires