Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades
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. Retrospective review of patients with pHPT who underwent routine bilateral neck exploration....
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| Veröffentlicht in: | The American journal of surgery 2024-07, Vol.233, p.61-64 |
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| creator | Beck, Tim N. Romero-Velez, Gustavo Noureldine, Salem I. Plitt, Gilman Wang, Sarah Jin, Judy |
| description | 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.
Retrospective review of patients with pHPT who underwent routine bilateral neck exploration.
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 |
| doi_str_mv | 10.1016/j.amjsurg.2024.02.008 |
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Retrospective review of patients with pHPT who underwent routine bilateral neck exploration.
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.
Despite changes in patient characteristics, single upper adenoma and bilateral double upper adenomas remain the most common findings for patients with pHPT.
•Changes in the biochemical profiles of patients with sporadic pHPT have been observed.•Abnormal upper glands were more common in patients with single or double adenoma.•The proportion of patients with double adenoma (DA) has increased significantly (22.6% vs. 17.3%; P < 0.01).•Knowledge of anatomic patterns for parathyroid adenomas can assist with surgical decision making.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2024.02.008</identifier><identifier>PMID: 38365553</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenoma ; Bilateral exploration ; Biochemistry ; Double adenoma ; Exploration ; Hyperparathyroidism ; Hyperplasia ; Multi-gland hyperplasia ; Osteoporosis ; Parathyroid hormone ; Parathyroidectomy ; Patients ; Primary hyperparathyroidism ; Surgery ; Tumors</subject><ispartof>The American journal of surgery, 2024-07, Vol.233, p.61-64</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c341t-d7f9d2ffa2d465e8301e7fe45926f0ab2ac8bc229acf883d5bbb0305c0821d4f3</cites><orcidid>0000-0002-4442-8944 ; 0000-0001-9549-6325</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/3065603098?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38365553$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beck, Tim N.</creatorcontrib><creatorcontrib>Romero-Velez, Gustavo</creatorcontrib><creatorcontrib>Noureldine, Salem I.</creatorcontrib><creatorcontrib>Plitt, Gilman</creatorcontrib><creatorcontrib>Wang, Sarah</creatorcontrib><creatorcontrib>Jin, Judy</creatorcontrib><title>Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>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.
Retrospective review of patients with pHPT who underwent routine bilateral neck exploration.
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.
Despite changes in patient characteristics, single upper adenoma and bilateral double upper adenomas remain the most common findings for patients with pHPT.
•Changes in the biochemical profiles of patients with sporadic pHPT have been observed.•Abnormal upper glands were more common in patients with single or double adenoma.•The proportion of patients with double adenoma (DA) has increased significantly (22.6% vs. 17.3%; P < 0.01).•Knowledge of anatomic patterns for parathyroid adenomas can assist with surgical decision making.</description><subject>Adenoma</subject><subject>Bilateral exploration</subject><subject>Biochemistry</subject><subject>Double adenoma</subject><subject>Exploration</subject><subject>Hyperparathyroidism</subject><subject>Hyperplasia</subject><subject>Multi-gland hyperplasia</subject><subject>Osteoporosis</subject><subject>Parathyroid hormone</subject><subject>Parathyroidectomy</subject><subject>Patients</subject><subject>Primary hyperparathyroidism</subject><subject>Surgery</subject><subject>Tumors</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkcuO1DAQRS0EYpqBTwBZYsMmoWzHaYcNguEpjcQG1pYfFdpREgc7GWjx83johgUbVlbZ595y1SXkMYOaAWufD7WZhrylrzUH3tTAawB1h-yY2ncVU0rcJTsA4FXXMrggD3IeSslYI-6TC6FEK6UUO_LzdRjNismMFH8sY0xmDXGmYaZLCpNJR3o4LpgWUx4OxxSDD3l6Qd_EzY5Ijcc5ToaWyzUFu_3WmtlTG6I74BRc8V3MWhrMmcYbTHT9HqlHV5T5IbnXmzHjo_N5Sb68e_v56kN1_en9x6tX15UTDVsrv-87z_vecN-0EpUAhvseG9nxtgdjuXHKOs474_oyt5fWWhAgHSjOfNOLS_Ls5Luk-G3DvOopZIfjaGaMW9a844o3TSf3BX36DzrELc3ld1pAK9vi26lCyRPlUsw5Ya_Py9IM9G06etDndPRtOhq4LukU3ZOz-2Yn9H9Vf-IowMsTgGUdNwGTzi7g7NCHhG7VPob_tPgFyHKmkA</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Beck, Tim N.</creator><creator>Romero-Velez, Gustavo</creator><creator>Noureldine, Salem I.</creator><creator>Plitt, Gilman</creator><creator>Wang, Sarah</creator><creator>Jin, Judy</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4442-8944</orcidid><orcidid>https://orcid.org/0000-0001-9549-6325</orcidid></search><sort><creationdate>20240701</creationdate><title>Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades</title><author>Beck, Tim N. ; Romero-Velez, Gustavo ; Noureldine, Salem I. ; Plitt, Gilman ; Wang, Sarah ; Jin, Judy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c341t-d7f9d2ffa2d465e8301e7fe45926f0ab2ac8bc229acf883d5bbb0305c0821d4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenoma</topic><topic>Bilateral exploration</topic><topic>Biochemistry</topic><topic>Double adenoma</topic><topic>Exploration</topic><topic>Hyperparathyroidism</topic><topic>Hyperplasia</topic><topic>Multi-gland hyperplasia</topic><topic>Osteoporosis</topic><topic>Parathyroid hormone</topic><topic>Parathyroidectomy</topic><topic>Patients</topic><topic>Primary hyperparathyroidism</topic><topic>Surgery</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beck, Tim N.</creatorcontrib><creatorcontrib>Romero-Velez, Gustavo</creatorcontrib><creatorcontrib>Noureldine, Salem I.</creatorcontrib><creatorcontrib>Plitt, Gilman</creatorcontrib><creatorcontrib>Wang, Sarah</creatorcontrib><creatorcontrib>Jin, Judy</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beck, Tim N.</au><au>Romero-Velez, Gustavo</au><au>Noureldine, Salem I.</au><au>Plitt, Gilman</au><au>Wang, Sarah</au><au>Jin, Judy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>233</volume><spage>61</spage><epage>64</epage><pages>61-64</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>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.
Retrospective review of patients with pHPT who underwent routine bilateral neck exploration.
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.
Despite changes in patient characteristics, single upper adenoma and bilateral double upper adenomas remain the most common findings for patients with pHPT.
•Changes in the biochemical profiles of patients with sporadic pHPT have been observed.•Abnormal upper glands were more common in patients with single or double adenoma.•The proportion of patients with double adenoma (DA) has increased significantly (22.6% vs. 17.3%; P < 0.01).•Knowledge of anatomic patterns for parathyroid adenomas can assist with surgical decision making.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38365553</pmid><doi>10.1016/j.amjsurg.2024.02.008</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-4442-8944</orcidid><orcidid>https://orcid.org/0000-0001-9549-6325</orcidid></addata></record> |
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| subjects | Adenoma Bilateral exploration Biochemistry Double adenoma Exploration Hyperparathyroidism Hyperplasia Multi-gland hyperplasia Osteoporosis Parathyroid hormone Parathyroidectomy Patients Primary hyperparathyroidism Surgery Tumors |
| title | Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades |
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