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Background: The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation.
Methods: A total of 236 patients were enrolled in this study between August 2019 and December 2020. RIPPT was employed to identify and protect the inferior parathyroid gland (IPG), and its identification rate and the anatomical variations were analyzed. The parathyroid hormone (PTH) and serum calcium levels were compared between patients who underwent IPG orthotopic retention and those who received IPG auto-transplantation, stratified by the anatomical type of the IPG.
Results: In total, the IPG identification rate was 97.88% (231/236), and the auto-transplantation rate was 74.46% (172/231). The anatomical relationship between IPG and thymus was observed in 77.97% of patients (184/236). Additionally, PTH levels were higher in patients with IPG orthotopic retention compared to those with IPG auto-transplantation both on postoperative day 1 (POD1) and at 6 months. PTH levels were also higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention compared to those who underwent both auto-transplantation procedures.
Conclusion: Retrograde inferior parathyroid protection technique (RIPPT) underscores the importance of protecting inferior parathyroid gland (IPG) in thyroid surgery and has been demonstrated to be effective in the rapid identification and functional preservation of IPG, based on short-term outcomes.
Clinical Trial Number: Not applicable.
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http://dx.doi.org/10.1186/s12902-025-01838-y | DOI Listing |
Background The accurate preoperative localization of parathyroid adenomas is crucial for minimally invasive parathyroidectomy (MIP) in primary hyperparathyroidism (PHPT). This study assessed the diagnostic performance of four-dimensional computed tomography (4D CT) in detecting parathyroid adenomas, compared with ultrasound (USG) and technetium methoxy isobutyl isonitrile single photon emission computed tomography (99mTc-sestamibi SPECT/CT). Methods We retrospectively analyzed 53 patients with biochemically confirmed PHPT who underwent all three preoperative imaging modalities, followed by parathyroidectomy from January 2020 to January 2025.
View Article and Find Full Text PDFJ Pediatr Endocrinol Metab
August 2025
Pediatric Endocrinology, Basaksehir Cam ve Sakura City Hospital, İstanbul, Türkiye.
Objectives: Parathyroid carcinoma is the rarest etiological cause of primary hyperparathyroidism and is exceedingly rare in the pediatric population. Clinical manifestations include severe hypercalcemia, pathological fractures, and bone pain. Diagnosis is typically established through surgical intervention and histopathological examination; however, genetic analyses can also support the diagnosis.
View Article and Find Full Text PDFChin Clin Oncol
August 2025
Department of Surgery, King Fahd Hospital, Jeddah, Saudi Arabia.
Background: Water-clear cell carcinoma of the parathyroid gland is an exceedingly rare malignancy, with the majority of published cases focusing on adenomas that are typically large and associated with mild elevations in parathyroid hormone (PTH) levels.
Case Description: We present the case of a 43-year-old woman who presented with a pelvic pathological fracture and very high serum calcium of 15.5 mg/dL, along with a severely elevated PTH level (>2,500 pg/mL).
JCEM Case Rep
September 2025
Division of Endocrinology, Department of Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA.
Primary hyperparathyroidism (PHPT) is rare in pregnancy and poses diagnostic challenges due to overlapping symptoms. This case series highlights diagnostic and management challenges in pregnant patients. Case 1: A 42-year-old woman at 33 weeks' gestation exhibited severe nausea and fatigue.
View Article and Find Full Text PDFChirurgie (Heidelb)
July 2025
Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinik Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
The identification of the parathyroid glands during neck surgery can be challenging due to their variable anatomical location. Knowledge of embryonic migration, typical positions and vascular supply is therefore essential for successful surgery of the parathyroid glands. This narrative review article, supported by a systematic literature search, addresses these aspects in detail.
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