Unilateral versus bilateral neck exploration for primary hyperparathyroidism: five-year follow-up of a randomized controlled trial.

摘要: Objective: To compare long-term patient outcome in a prospective randomized controlled trial between unilateral and bilateral neck exploration for primary hyperparathyroidism (pHPT). Summary Background Data: Minimal invasive and/or focused parathyroidectomy has challenged the traditional pHPT. Between 1997 2001, we conducted first unselected of versus The results showed that is surgical strategy with distinct advantages early postoperative period. However, concerns have been raised limited parathyroid could increase risk recurrent pHPT during follow-up. Methods: Ninety-one patients diagnosis were to or exploration. Preoperative scintigraphy intraoperative hormone measurement guided Gross morphology frozen section determined extent tissue resection group. Follow-up was performed after 6 weeks, I year, 5 years postoperatively. Results: Seventy-one available 5-year There no differences serum ionized calcium hormone, respectively, Overall found persistent (n = 3) pHPT; 4 group (3 these bilaterally explored) 2 Three failures unexpectedly multiple endocrine neoplasia mutations. One solitary adenoma still required vitamin D substitution surgery. Conclusion: Unilateral assessment provides same as exploration, thus valid treatment (Less)