[Are preoperative examinations useful in the management of patients with renal hyperparathyroidism?].
OBJECTIVE
To evaluate the efficiency of preoperative parathyroid ultrasonography and scintigraphy in the management of renal hyperparathyroidism.


METHODS
The charts of the last consecutive 200 patients who underwent surgery for renal hyperparathyroidism from 1998 to 2003 were retrospectively reviewed to collect data concerning parathyroid gland function, results of preoperative ultrasonography and scintigraphy, as well as modalities and results of surgical exploration.


RESULTS
Ultrasonography and scintigraphy sensibilities were 36.4% and 49.3%, respectively. Efficiency of both examinations was improved when they were combined (sensibility of 64.7%) and in those patients managed for recurrent hyperparathyroidism. Were more often detected by preoperative examinations glands with high weight and/or greatest diameter, orthotopic and inferior glands as well as glands exhibiting nodular hyperplasia content upon pathological examination.


CONCLUSIONS
Parathyroid ultrasonography and scintigraphy are of poor interest in the management of renal hyperparathyroidism. In a preoperative setting, they should be performed only in patients with recurrent disease.
Guillem
P
P
Service de chirurgie générale et endocrinienne, hôpital Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France. guillem.philippe@wanadoo.fr
Vlaeminck-Guillem
V
V
Dracon
M
M
Noel
C
C
Cussac
J F
JF
Huglo
D
D
Proye
C
C
D000328:Adult; D000368:Aged; D001835:Body Weight; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D010347:Patient Care Planning; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D011877:Radionuclide Imaging; D012008:Recurrence; D051437:Renal Insufficiency / Q000150:complications*; D014463:Ultrasonography