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Purpose: We conducted this study to evaluate the feasibility, patient satisfaction, and cost of performing focused parathyroidectomy under local anesthesia (LA) and mild sedation, administered and monitored by a surgeon.
Materials And Methods: This was a prospective observational study of 30 patients with primary hyperparathyroidism (PHPT) undergoing a focused parathyroidectomy under LA and mild sedation at a single institution. The clinical features, gland weight, operating time, procedure time, postoperative pain scores, overall patient satisfaction, postoperative nausea and vomiting, analgesic requirements, complications, cost, and cure rates were documented. Data were analyzed using SPSS software version 17.0.
Results: In two patients (6.7%), the procedure had to be completed under general anesthesia (GA). Postoperative temporary hypocalcemia was witnessed in 14 of 30 (46.7%), but only 1 required intravenous calcium infusion. About 21 of 30 (75%) were completely satisfied with LA, whereas 25 of 30 (89%) were completely satisfied with surgical procedure. Furthermore, all patients were keen to recommend this procedure under LA to their friends and family. Comparing the cost between performing the procedure under LA with that under GA, a significant difference was witnessed ( = 0.001). Among the 26 patients reviewed at 6 months, all had a normal serum calcium and parathyroid hormone levels indicating 100% cure rate.
Conclusion: Performing focused parathyroidectomy under LA is feasible; additionally, this method can significantly reduce the cost of the procedure ( = 0.001).
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http://dx.doi.org/10.4103/ijem.IJEM_590_18 | DOI Listing |
Genes (Basel)
August 2025
Endocrinology Unit, Department of Medicine (DIMED), Via Ospedale Civile 105, 35128 Padua, Italy.
This study investigates the role of CASR gene polymorphisms (A986S, R990G, Q1011E) in PHPT genetic susceptibility and its clinical variability. The aim is to evaluate the prevalence of these polymorphisms in patients with sporadic PHPT and their impact on clinical course, biochemistry, and histological features. 106 patients underwent clinical and anamnestic evaluations, focusing on major PHPT complications, as well as biochemical analyses of blood and urine.
View Article and Find Full Text PDFJ Surg Res
August 2025
University of Alabama at Birmingham, Department of Surgery, Birmingham, Alabama. Electronic address:
Introduction: Central neck hematomas (CNHs) after thyroidectomy and parathyroidectomy are rare but potentially life-threatening complications. Many surgeons are reluctant to perform these operations in an ambulatory facility with same-day discharge due to this fear, and most admit patients for 24 h or more for observation. As our institution frequently deals with inpatient bed shortage, surgical cases are limited.
View Article and Find Full Text PDFBJS Open
July 2025
Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Background: Accurate preoperative localization is essential for successful, focused, minimally invasive surgery in primary hyperparathyroidism (PHPT). New imaging techniques have recently been proposed. This study evaluated the impact of 18F-choline positron emission tomography (PET)-computed tomography or 18F-choline PET-magnetic resonance imaging (FCh) in patients with negative or inconclusive results on neck ultrasonography (US) and 99mTc-sestamibi (MIBI) scintigraphy.
View Article and Find Full Text PDFBioanalysis
July 2025
Department of Chemistry, Koneru Lakshmaiah Education Foundation, Hyderabad, India.
Aims: This study aims to address the clinical need for managing secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients on dialysis and hypercalcemia in individuals with parathyroid carcinoma or primary hyperparathyroidism (PHPT) ineligible for parathyroidectomy. Cinacalcet, a key calcimimetic agent, targets the calcium-sensing receptor (CaSR) in the parathyroid gland to lower elevated parathyroid hormone (PTH) levels. The study focuses on developing a robust high-performance liquid chromatography tandem mass spectrometry method for cinacalcet quantification to support therapeutic monitoring and pharmacokinetics.
View Article and Find Full Text PDFJ Clin Med
July 2025
Department X, Discipline of General Surgery I, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.
: Secondary hyperparathyroidism (SHPT) is a prevalent complication in end-stage renal disease, often necessitating surgical intervention when refractory to medical therapy. The optimal surgical strategy-subtotal parathyroidectomy (SPTX) versus total parathyroidectomy with/without autotransplantation (TPTX ± AT)-remains debated, especially considering postoperative complications like persistent HPT and hungry bone syndrome (HBS). This study aimed to compare early surgical outcomes and identify predictors for postoperative complications in patients undergoing SPTX and TPTX + AT.
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