title: Ambulatory bilateral neck exploration for primary hyperparathyroidism: is it safe?
abstract: BACKGROUND
  We sought to determine if bilateral neck exploration (BNE) for hyperparathyroidism could be performed safely in an ambulatory setting (same-day discharge) when compared with focused parathyroidectomy.
  
  
  METHODS
  A retrospective review of 503 patients who underwent parathyroidectomy from 2010 to 2015 was performed. Focused parathyroidectomy was compared with BNE. Only patients with positive localization and no prior operations were included.
  
  
  RESULTS
  Forty-nine percent of patients underwent focused parathyroidectomy and 51% had BNE. BNE patients were more likely to have 1 or more glands removed (35% vs 14%, P < .01) and longer operative times (median 50 vs 41 minutes, P < .01). There were no differences in the rate of same-day discharge, transient hypocalcemia, emergency department visits, and readmissions.
  
  
  CONCLUSIONS
  In this study, BNE for hyperparathyroidism was associated with excision of more parathyroid glands and slightly longer operative times. However, BNE had equal rates of same-day discharges and safety profile.
authors.affiliation: Department of Surgery, Vanderbilt University, Nashville, TN, USA. Electronic address: colleen.m.kiernan@vanderbilt.edu.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Kiernan
authors.affiliation: Department of Surgery, Vanderbilt University, Nashville, TN, USA.
authors.forename: Cameron
authors.initials: C
authors.lastname: Schlegel
authors.affiliation: Department of Surgery, Vanderbilt University, Nashville, TN, USA.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Isom
authors.affiliation: Department of Surgery, Vanderbilt University, Nashville, TN, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Kavalukas
authors.affiliation: Department of Anesthesiology, Vanderbilt University, Nashville, TN, USA.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Peters
authors.affiliation: Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, TN, USA.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Solórzano
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D006996:Hypocalcemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000601:surgery*; D016105:Parathyroidectomy; D011183:Postoperative Complications; D012189:Retrospective Studies; D014463:Ultrasonography
keywords: Ambulatory; Bilateral exploration; Complications; Focused parathyroidectomy; Outpatient; Parathyroidectomy