Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades
The American Journal of Surgery(2024)
摘要
Background
We investigated if anatomic patterns of abnormal parathyroid glands have ch anged for primary hyperparathyroidism (pHPT) as atypical biochemical presentation (normohormonal and normocalcemic) has increased.
Methods
Retrospective review of patients with pHPT who underwent routine bilateral neck exploration.
Results
2762 patients were included. The “late” cohort (2014–2020) exhibited lower preoperative calcium (10.8 vs 11.1 mg/dL; P = 0.001) and PTH levels (101 vs. 146 pg/mL; P = 0.001) compared to the “early” cohort (2000–2006). Patients with atypical biochemical profiles increased from 25.5% to 31.3% (P < 0.001). The prevalence of single adenoma (SA) decreased (66.1% vs 58.9%, P = 0.02) while the proportion of double adenoma (DA) increased (17.3% vs. 22.6%, P < 0.01). Upper parathyroid adenoma(s) remained the most common finding for SA and DA in both time points.
Conclusions
Despite changes in patient characteristics, single upper adenoma and bilateral double upper adenomas remain the most common findings for patients with pHPT.
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关键词
Primary hyperparathyroidism,Parathyroidectomy,Bilateral exploration,Double adenoma,Multi-gland hyperplasia
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