The impact of minimally invasive parathyroidectomy on the way endocrinologists treat primary hyperparathyroidism

Minimally-invasive parathyroidectomy (MIP) appears to be changing preoperative treatment and referral patterns for sporadic, nonfamilial, non–multiple endocrine neoplasia, primary hyperparathyroidism (PHPT). The American Association of Clinical Endocrinologists membership was surveyed by mail ( n = 1406 members) regarding physician practices and surgical referral patterns for PHPT. Seven hundred eighty-eight respondents (56%) practiced 17.0±0.4 years and referred 63%±1% of patients with PHPT for operation. Most endocrinologists (90%) used localizing studies before surgical referral (sestamibi, ultrasound scanning, technetium/thallium scanning, magnetic resonance imaging, computed tomography). Respondents identified symptoms, calcium homeostasis, bone density, health status, age, and general anesthesia risk as the most important considerations for surgical referral. Most respondents (79%) indicated that MIP availability would increase the number of patients who were referred for operation ( P