title: A 20-year study on 190 patients with primary hyperparathyroidism in a developing country: Turkey experience.
abstract: The aim of this study was to present our 20-year experience regarding primary hyperparathyroidism (PHPT). PHPT patients who underwent parathyroidectomy in our clinic were reviewed retrospectively. There were 190 PHPT patients, of whom 137 were asymptomatic (72%). The mean serum calcium at the time of diagnosis was 11.9 ± 2.2 mg/dL. The mean parathyroid hormone (PTH) level was 467 ± 78 pg/mL. Ultrasonography (USG) identified all abnormal glands accurately (82.6%) and Technetium-99m sestamibi scintigraphy (MIBI) was used in 89.4% of the patients and magnetic resonance imaging (MRI) in 61%. The common use of USG and MIBI detected 92% of the lesions. Bilateral neck exploration (BNE) was performed in 12.2% of the patients and focused unilateral neck exploration (FUNE) in the remaining 87.8%. Surgical intervention was unsuccessful in 1 patient (0.5%). The conversion ratio from FUNE to BNE was 5.2%. The mean operation time and mean hospital stay decreased significantly in patients with FUNE. Pathologic examination revealed single adenoma in 93% of the patients. New imaging techniques result in the conversion of surgical treatments of PHPT. FUNE in parathyroidectomy performed by an experienced surgeon may provide successful treatment rates.
authors: 1 Department of Surgery, State Hospital, Karabük, Turkey.
authors: Arif
authors: A
authors: Usta
authors: Etem
authors: E
authors: Alhan
authors: Akif
authors: A
authors: Cinel
authors: Serdar
authors: S
authors: Türkyılmaz
authors: Cihangir
authors: C
authors: Erem
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003906:Developing Countries; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016105:Parathyroidectomy / Q000379:methods*; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology
keywords: Developing country; Focused surgical neck exploration; Primary hyperparathyroidism