Parathyroid Surgery
Parathyroid surgery
is the surgical treatment of hyparaparathyroidism. When performed by a surgeon experienced in parathyroid surgery, neck exploration for hyperparaparathyroid ism has about a 96% success rate in curing hyperparaparathyroid ism. That means that there is about a 4% chance of the operation not correcting the hyperparaparathyroid ism.
There are basically 3 reasons why parathyroid surgery might not correct the problem. First, the diagnosis might not be correct. There are a number of different things which can elevate the calcium in the blood, including cancers, some medications, some inflammatory conditions, etc.. The amount of paraparathyroid hormone in the blood can now be measured accurately, and proper interpretation of the results of this test has greatly increased the accuracy of diagnosis of hyperparaparathyroidism. Secondly, the surgeon may not be able to locate the abnormal paraparathyroid gland or gland in the neck. Surgeons who do a lot of parathyroid surgery are more likely to be able to find the abnormal glands, but even very experienced surgeons will not always be able to find all of the abnormal paraparathyroid glands and thereby correct the hyperparaparathyroid ism . Thirdly, very occasionally the abnormal paraparathyroid gland or glands are not in the neck but in the chest, in which case, obviously, even the best paraparathyroid surgeon cannot find it by looking in the neck.
There are many different types of scans which can be done before parathyroid surgery to try to find the abnormal paraparathyroid gland or glands. These include sonic or ultrasound scans, CAT scans, MRI scans, and nuclear medicine sestamibi scans. These scans, even taken all together, are not as successful at localizing all of the abnormal paraparathyroid as is an experienced paraparathyroid surgeon. Therefore most endocrine surgeons do not think these scans are necessary or useful prior to parathyroid surgery unless the newer "minimally invasive radioguided" approach discussed below is used. Theses scans can be useful when patients have recurrent or persistent disease after a previous operation for hyperparaparathyroid ism, however, or when patients have had previous parathyroid surgery.
Learn more about parathyroid surgery and additional General Surgery procedures at the Wake Forest University Baptist Medical Center. One of the nation's preeminent academic medical centers, WFUBMC is an integrated health care system that operates 1,291 acute care, rehabilitation and long-term care beds, outpatient services, and community health and information centers. The Medical Center's component institutions carry out a joint mission of patient care, education, research and community service. The partnership includes three major members: Wake Forest University Health Sciences, North Carolina Baptist Hospital, and Wake Forest University Physicians.
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