Skip to main content

Bilateral Exploration for Hyperparathyroidism

  • Chapter
  • First Online:
Atlas of Parathyroid Surgery
  • 648 Accesses

Abstract

A bilateral neck exploration (BNE) is a fundamental skill for any surgeon involved in the treatment of parathyroid disease, and it remains the gold standard procedure for the management of hyperparathyroidism (HPT). In experienced hands, it is a safe and highly effective procedure. Furthermore, it is a cost-effective operation that can be performed anywhere in the world, without need for sophisticated preoperative imaging modalities or intra-operative surgical adjuncts. This chapter describes the morphological information and technical steps that facilitate performing this operation in a safe and efficient manner.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Siperstein A, Berber E, Barbosa GF, Tsinberg M, Greene AB, Mitchell J, et al. Predicting the success of limited exploration for primary hyperparathyroidism using ultrasound, sestamibi, and intraoperative parathyroid hormone: analysis of 1158 cases. Ann Surg. 2008;248(3):420–8.

    PubMed  Google Scholar 

  2. Norman J, Lopez J, Politz D. Abandoning unilateral parathyroidectomy: why we reversed our position after 15,000 parathyroid operations. J Am Coll Surg. 2012;214(3):260–9.

    Article  Google Scholar 

  3. Starker LF, Akerstrom T, Long WD, Delgado-Verdugo A, Donovan P, Udelsman R, et al. Frequent germ-line mutations of the MEN1, CASR, and HRPT2/CDC73 genes in young patients with clinically non-familial primary hyperparathyroidism. Horm Cancer. 2012;3(1–2):44–51.

    Article  CAS  Google Scholar 

  4. Udelsman R. Six hundred fifty-six consecutive explorations for primary hyperparathyroidism. Ann Surg. 2002;235(5):665–70; discussion 670–2.

    Article  Google Scholar 

  5. Allendorf J, DiGorgi M, Spanknebel K, Inabnet W, Chabot J, Logerfo P. 1112 consecutive bilateral neck explorations for primary hyperparathyroidism. World J Surg. 2007;31(11):2075–80.

    Article  Google Scholar 

  6. Gupta PK, Smith RB, Gupta H, Forse RA, Fang X, Lydiatt WM. Outcomes after thyroidectomy and parathyroidectomy. Head Neck. 2012;34(4):477–84.

    Article  Google Scholar 

  7. Udelsman R, Lin Z, Donovan P. The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism. Ann Surg. 2011;253(3):585–91.

    Article  Google Scholar 

  8. Udelsman R, Åkerström G, Biagini C, Duh QY, Miccoli P, Niederle B, et al. The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the fourth international workshop. J Clin Endocrinol Metab. 2014;99(10):3595–606.

    Article  CAS  Google Scholar 

  9. Bergenfelz A, Lindblom P, Tibblin S, Westerdahl J. Unilateral versus bilateral neck exploration for primary hyperparathyroidism: a prospective randomized controlled trial. Ann Surg. 2002;236(5):543–51.

    Article  Google Scholar 

  10. Karakas E, Schneider R, Rothmund M, Bartsch DK, Schlosser K. Initial surgery for benign primary hyperparathyroidism: an analysis of 1,300 patients in a teaching hospital. World J Surg. 2014;38(8):2011–8.

    Article  Google Scholar 

  11. Wang CA. Surgical management of primary hyperparathyroidism. Curr Probl Surg. 1985;22(11):1–50.

    Article  CAS  Google Scholar 

  12. Tibblin S, Bondeson AG, Bondeson L, Ljungberg O. Surgical strategy in hyperparathyroidism due to solitary adenoma. Ann Surg. 1984;200(6):776–84.

    Article  CAS  Google Scholar 

  13. Fyrsten E, Norlén O, Hessman O, Stålberg P, Hellman P. Long-term surveillance of treated hyperparathyroidism for multiple endocrine neoplasia type 1: recurrence or hypoparathyroidism? World J Surg. 2016;40(3):615–21.

    Article  Google Scholar 

  14. Rajaei MH, Oltmann SC, Schneider DF, Sippel RS, Chen H. Outcomes after subtotal parathyroidectomy for primary hyperparathyroidism due to hyperplasia: significance of whole vs. partial gland remnant. Ann Surg Oncol. 2015;22(3):966–71.

    Article  Google Scholar 

  15. Schreinemakers JM, Pieterman CR, Scholten A, Vriens MR, Valk GD, Rinkes IH. The optimal surgical treatment for primary hyperparathyroidism in MEN1 patients: a systematic review. World J Surg. 2011;35(9):1993–2005.

    Article  Google Scholar 

  16. Albuquerque RFC, Carbonara CEM, Martin RCT, Dos Reis LM, do Júnior NCP, Arap SS, et al. Parathyroidectomy in patients with chronic kidney disease: impacts of different techniques on the biochemical and clinical evolution of secondary hyperparathyroidism. Surgery. 2018;163(2):381–7.

    Article  Google Scholar 

  17. d’Alessandro AF, Montenegro FL, Brandão LG, Lourenço DM, Toledo Sde A, Cordeiro AC. Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1. Rev Assoc Med Bras (1992). 2012;58(3):323–7.

    Article  Google Scholar 

  18. Mirallié É, Caillard C, Pattou F, Brunaud L, Hamy A, Dahan M, et al. Does intraoperative neuromonitoring of recurrent nerves have an impact on the postoperative palsy rate? Results of a prospective multicenter study. Surgery. 2018;163(1):124–9.

    Article  Google Scholar 

  19. Tonelli F, Marcucci T, Giudici F, Falchetti A, Brandi ML. Surgical approach in hereditary hyperparathyroidism. Endocr J. 2009;56(7):827–41.

    Article  Google Scholar 

  20. Stålberg P, Carling T. Familial parathyroid tumors: diagnosis and management. World J Surg. 2009;33(11):2234–43.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steven Craig .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pasieka, J.L., Craig, S. (2020). Bilateral Exploration for Hyperparathyroidism. In: Shifrin, A. (eds) Atlas of Parathyroid Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-40756-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-40756-8_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-40755-1

  • Online ISBN: 978-3-030-40756-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics