TY - JOUR
T1 - Fewer adverse events after reoperative parathyroidectomy associated with initial minimally invasive parathyroidectomy
AU - Morris, Lilah F.
AU - Lee, Sukhyung
AU - Warneke, Carla L.
AU - Abadin, Shabir S.
AU - Suliburk, James W.
AU - Romero Arenas, Minerva A.
AU - Lee, Jeffrey E.
AU - Grubbs, Elizabeth G.
AU - Perrier, Nancy D.
N1 - Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Results Seventy-seven patients were included; 74% underwent initial standard cervical exploration. Preoperative and operative characteristics were similar between groups; 74% underwent focused, unilateral reoperation. A significantly higher rate of postoperative complications occurred in the initial standard cervical exploration group (42% vs 15%, P =.03) that could not be explained by differences in the rates of symptomatic hypocalcemia (P =.5). The type of prior parathyroidectomy was significantly associated with postoperative complications (odds ratio 4.1, 95% confidence interval 1.1 to 15.7, P =.04). In a multivariable logistic regression model that included body mass index, type of operation (for initial and reoperation), and initial operation performed prereferral as covariates, type of prior parathyroidectomy remained a significant predictor of postoperative complications.Conclusion Higher rates of postoperative sequelae after initial standard cervical exploration should be considered before performing routine 4-gland exploration.Background This study compared reoperative complication rates after initial minimally invasive parathyroidectomy and standard cervical exploration.Methods Records from patients who underwent 1 reoperative parathyroidectomy at a single institution (1998 to 2012) were retrospectively reviewed.
AB - Results Seventy-seven patients were included; 74% underwent initial standard cervical exploration. Preoperative and operative characteristics were similar between groups; 74% underwent focused, unilateral reoperation. A significantly higher rate of postoperative complications occurred in the initial standard cervical exploration group (42% vs 15%, P =.03) that could not be explained by differences in the rates of symptomatic hypocalcemia (P =.5). The type of prior parathyroidectomy was significantly associated with postoperative complications (odds ratio 4.1, 95% confidence interval 1.1 to 15.7, P =.04). In a multivariable logistic regression model that included body mass index, type of operation (for initial and reoperation), and initial operation performed prereferral as covariates, type of prior parathyroidectomy remained a significant predictor of postoperative complications.Conclusion Higher rates of postoperative sequelae after initial standard cervical exploration should be considered before performing routine 4-gland exploration.Background This study compared reoperative complication rates after initial minimally invasive parathyroidectomy and standard cervical exploration.Methods Records from patients who underwent 1 reoperative parathyroidectomy at a single institution (1998 to 2012) were retrospectively reviewed.
KW - Minimally invasive parathyroidectomy
KW - Persistent or recurrent hyperparathyroidism
KW - Primary hyperparathyroidism
KW - Reoperative parathyroidectomy
KW - Standard cervical exploration
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U2 - 10.1016/j.amjsurg.2014.05.006
DO - 10.1016/j.amjsurg.2014.05.006
M3 - Article
C2 - 25152254
AN - SCOPUS:84910655570
SN - 0002-9610
VL - 208
SP - 850
EP - 855
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 5
ER -