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Osteitis Fibrosa Cystica
Published in Charles Theisler, Adjuvant Medical Care, 2023
Regardless of the clinical severity of primary hyperparathyroidism, the disease is generally more severe in those with concomitant vitamin D deficiency. Second, vitamin D deficiency and insufficiency seem to be more prevalent in patients with primary hyperparathyroidism than in geographically matched populations.3 In some cases, correction of vitamin D deficiency may be accomplished without worsening the underlying hypercalcemia. Vitamin D-deficient patients undergoing parathyroidectomy are also at increased risk of postoperative hypocalcemia and “hungry bone syndrome,” which underscores the importance of preoperative assessment of vitamin D status in all patients with primary hyperparathyroidism.3 Taking vitamin D3 by mouth lowers parathyroid hormone levels and bone loss in women with hyperparathyroidism.4
Parathyroid surgery in children
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Rajshri M. Gartland, Jessica Fazendin, Herbert Chen
The main complications after parathyroidectomy include bleeding, infection, unilateral or bilateral recurrent laryngeal nerve injury, and hypoparathyroidism and hypocalcemia. Multiple studies have demonstrated that children are at higher risk of general and endocrine-specific complications after parathyroidectomy compared to adults, and that this risk is related to both pre-existing kidney disease and to age, with more complications occurring in younger children. In light of this increased risk of postoperative complications in the pediatric population, as well as the increased rate of ectopic parathyroid adenomas in children, children undergoing parathyroidectomy benefit from multi-specialty care that includes the expertise of high-volume endocrine surgeons.
Endocrine Disorders
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Definitive: Parathyroidectomy ➣ The four parathyroid glands are typically pea-sized and found on the posterior aspect of the thyroid gland.➣ Isolating the responsible gland prior to surgery may allow for a minimally invasive technique to be employed.➣ Intraoperative PTH measurement can provide evidence of curative surgery.➣ Serum calcium must be monitored during the postoperative period.
Penile calciphylaxis with extragenital gangrene
Published in Baylor University Medical Center Proceedings, 2021
Marcus Zaayman, Annika Silfvast-Kaiser, Edgar Rodriguez, Andrew J. DeCrescenzo, Alan Menter
Treatment for PC must consider noninvasive vs invasive approaches (Table 2).2,4–7,12 Three interventional approaches are supported in formal literature: excision of the affected tissue, revascularization, and parathyroidectomy.8,13,14 Yang et al6 found that 21 patients receiving partial or total penectomy showed no significant improvement in mortality rates over those with local wound care (42.9% vs 52%, respectively). Penectomy should be reserved for severe refractory pain or uncontrolled infection.6,8 Data concerning revascularization surgery are sparse. Successful revascularization from the left femoral artery to the deep dorsal penile vein and endovascular interventions have been separately reported.13,15 Parathyroidectomy for PC is controversial.6,8 In systemic calciphylaxis patients, the median survival time is increased by approximately 8 months with parathyroidectomy.14 Parathyroidectomy should only be considered in patients with concomitant severe hyperparathyroidism.
Ultrasound-guided microwave ablation for secondary hyperparathyroidism: a systematic review and meta-analysis
Published in International Journal of Hyperthermia, 2021
Xiaofeng Zhou, Yang Shen, Ying Zhu, Qiang Lv, Weiyu Pu, Leiping Gao, Mingjia Gu, Chao Li
Secondary hyperparathyroidism (SHPT) is a frequently encountered problem in patients with end-stage renal disease (ESRD) [1,2], and about one-third of the patients undergoing long-term dialysis are affected [3,4]. The patients with uncontrolled SHPT have increased risk of fractures and mortality [5,6]. Although disease development can be controlled clinically by using intravenous vitamin D analogs [7], orally active vitamin D sterols [8] and cinacalcet [9], parathyroidectomy in patients with severe SHPT is still considered necessary [10]. Surgical parathyroidectomy exposes patients to anesthesia risks and permanent parathyroid function reduction [11]. A minimally invasive alternative treatment with potential advantages of reduced risk, faster recovery, fewer side effects and lower costs when compared to traditional surgical treatment is warranted.
Efficacy and safety of US-guided thermal ablation for primary hyperparathyroidism: a systematic review and meta-analysis
Published in International Journal of Hyperthermia, 2020
Jieyi Ye, Weijun Huang, Guangliang Huang, Yide Qiu, Weiwei Peng, Ninghui Lan, Xiaoyan Xie, Baoxian Liu
Surgical treatment with extirpation of pathologic parathyroid tissue still remains the main curative treatment of PHPT [12]. Although parathyroidectomy is recommended for patients who meet the indications of surgery in the clinic, it is considered to be high risk and associated with several complications, such as wound infection, post-operative hemorrhage, recurrent laryngeal nerve injury, persistent hypoparathyroidism and hypocalcemia [13]. Though with improved surgical techniques, there are patients who either refuse surgical treatment or are ineligible for surgery. Senile patients suffer from risk to receive general anesthesia and full neck exploration [14], and young female patients are anxious about the possibility of scar formation on their necks after surgery. In addition, parathyroidectomy requires initial image localization techniques to identify the adenoma, which are less successful for investigation of patients with mild hypercalcemia and in identification of multiple glands [15]. Therefore, it has been warranted to identify therapeutic alternatives to surgical treatment.