title: Operative treatment of primary hyperparathyroidism: balancing cost-effectiveness with successful outcomes.
abstract: Parathyroidectomy is the most cost-effective treatment for hyperparathyroidism. Randomized prospective trials have shown no difference in cure rate between focused parathyroidectomy and bilateral exploration. Costs of the two techniques differ depending on the preoperative and intraoperative localization used, speed of the operation, ability to discharge the patient on the same day as the operation, cure rate, and complications. It may be less costly and more effective to use a policy of routine 4-gland exploration without the use of preoperative or intraoperative localization studies. The potential economic impact and the expected outcome of the various strategies should be formally evaluated.
authors.affiliation: Section of Endocrine Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Chicago, IL 60611, USA.
authors.forename: Dina
authors.initials: D
authors.lastname: Elaraj
authors.affiliation: Section of Endocrine Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Chicago, IL 60611, USA. Electronic address: csturgeo@nmh.org.
authors.forename: Cord
authors.initials: C
authors.lastname: Sturgeon
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000191:economics / Q000601:surgery*; D016105:Parathyroidectomy / Q000191:economics*; D016896:Treatment Outcome
keywords: Cost-effectiveness; Hyperparathyroidism; Outcomes; Parathyroidectomy