title: Parathyroidectomy outcomes according to operative approach.
abstract: BACKGROUND
  Parathyroidectomy for primary sporadic hyperparathyroidism (psHPT) has evolved with advances in preoperative gland localization and intraoperative parathyroid hormone (ioPTH) monitoring to minimally invasive approaches (MIPS).
  
  
  METHODS
  Two hundred twenty patients underwent parathyroidectomy for psHPT. Forty-nine patients underwent bilateral neck exploration (BNE) (group 1), 60 patients underwent BNE with ioPTH monitoring (group 2), and 111 patients underwent MIPS with ioPTH monitoring (group 3).
  
  
  RESULTS
  At 3 months postoperatively, mean serum calcium and intact parathyroid hormone (PTH) levels were similar between groups, and eucalcemia rates were 100%, 100%, and 99%. The ultimate rates of persistent disease and recurrence were also similar. Operative time was shorter in group 3 compared to group 2 (P < .001) but not group 1. Frozen sections and patient charges were significantly lower in group 3 compared to groups 1 and 2 (P < .005).
  
  
  CONCLUSIONS
  Parathyroidectomy for psHPT is highly successful with these techniques. When a MIPS approach can be done, it is potentially quicker and associated with lower patient charges.
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: Todd D
authors.initials: TD
authors.lastname: Beyer
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Solorzano
authors.forename: Fred
authors.initials: F
authors.lastname: Starr
authors.forename: Naris
authors.initials: N
authors.lastname: Nilubol
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prinz
mesh_terms: D002118:Calcium / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D012008:Recurrence; D061226:Recurrent Laryngeal Nerve Injuries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium