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. 2022 Oct;74(Suppl 2):2513-2519.
doi: 10.1007/s12070-020-02216-x. Epub 2020 Nov 4.

Prospective Audit and Review of Parathyroid Surgery in Rural Setting

Faiz Tanweer #  1 , Paul Zhaobo Liu #  2 , Nilesh Vakharia  2 , Katherine Whitcroft  3
Affiliations

Prospective Audit and Review of Parathyroid Surgery in Rural Setting

Faiz Tanweer et al. Indian J Otolaryngol Head Neck Surg. 2022 Oct.

Abstract

Primary hyperparathyroidism (PHPT) is a common condition associated with significant morbidity and mortality. Recently Endocrine multidisciplinary team (MDT) has greatly influenced the care of such patient and has helped in improving the outcome and reducing the complications related with surgery. We conducted a review of prospectively collected data of all consecutive parathyroidectomies carried out in our district general hospital between October 2016 and Jan 2020 by a single surgeon. The collected data include patient's characteristics, laboratory results, radiological findings and operative outcomes. There were 53 parathyroidectomies performed during this period for PHPT. Mean age of patients was 75 years. Our results demonstrated a reduction in post-operative PTH in 46 patients (92%). We have identified no cases of vocal cord palsy, significant neck haemorrhage or mortality. 6 patients had temporary hypocalcaemia and 2 patients had hungry bone syndrome. Patient selection and evaluation for parathyroidectomies under endocrine MDT has greatly influenced the outcome for our patients. We had low complication rate and surgery was done at a more convenient location for selected patients. We benefit from dedicated monthly parathyroid clinic and weekly endocrine multidisciplinary team meetings to assist with patient selection and optimisation. A team effort helps in reducing complications and improving outcomes. We feel that surgery can be provided safely and successfully in a district general hospital in rural settings.

Keywords: Hyperparathyroidism; Parathyroidectomy; Primary hyperparathyroidism.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Giant parathyroid adenoma
Fig. 2
Fig. 2
Comparison of pre and post-operative adjusted serum calcium level
Fig. 3
Fig. 3
Comparison of pre and post-operative serum parathyroid hormone level
Fig. 4
Fig. 4
Spearman correlation (r = 0.32, n = 49, p = 0.029)
Fig. 5
Fig. 5
(i) T-score of BMD at spine in DEXA scan (ii) T-score of BMD at hip in DEXA scan
Fig. 6.
Fig. 6.
18F Fluorocholine PET in patient where USS localisation was negative
See this image and copyright information in PMC

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