caa a22 4500 445336196 CHVBK 20180317142756.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1394-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1394-4 Shifting Incidence of Solitary Adenomas in the Era of Minimally Invasive Parathyroidectomy. A Multi-Institutional Study [Elektronische Daten] [Bas Twigt, Anne Vollebregt, Thijs van Dalen, A. Smits, E. Consten, Theo van Vroonhoven, Menno Vriens, Inne Borel Rinkes] Background: Previously, when a conventional neck exploration (CNE) without preceding diagnostic imaging was the surgical treatment for patients with primary hyperparathyroidism (pHPT) solitary adenomas were observed in 69-88% of patients. The advent of minimally invasive parathyroidectomy (MIP), aiming at a preoperatively identified parathyroid abnormality may be associated with a different incidence of solitary and multiglandular parathyroid disease. Materials and Methods: In a cohort of 467 patients with sporadic pHPT who preferentially underwent MIP in four hospitals in the same geographical region, the incidence of solitary adenomas, multiple adenomas, and multiglandular hyperplasia (MGD) was evaluated. Results: A total of 367 patients were scheduled for MIP; 100 patients underwent a planned CNE. The overall surgical success rate of the first operation was 93%, and the cumulative success rate, including a second operative procedure, was 99%. Normocalcemia resulted from removing 1 abnormal PG in 426 patients (91%) and more than one abnormal gland in 35 patients (8%). A parathyroid carcinoma was diagnosed in four of the 426 patients with a single abnormal gland. Four gland hyperplasia was observed in 1 patient. In hospitals where diagnostic workup usually consisted of ultrasound (US) and computed tomography (CT) the incidence of solitary adenomas was 88%, compared with 96% in hospitals where MIBI, US, and CT were used preoperatively (P=0.007). Conclusions: A higher frequency of solitary adenomas was observed than historically reported. The extent of the preoperative workup influences the number of observed solitary adenomas. Society of Surgical Oncology, 2010 Twigt Bas Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut Vollebregt Anne Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut van Dalen Thijs Department of Surgery, Diakonessen Hospital Utrecht, Utrecht, The Netherlands aut Smits A. Department of Surgery, St. Antonius Hospital, Utrecht, The Netherlands aut Consten E. Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands aut van Vroonhoven Theo Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut Vriens Menno Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut Borel Rinkes Inne Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1041-1046 1068-9265 18:4<1041 2011 18 10434 https://doi.org/10.1245/s10434-010-1394-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1394-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Twigt Bas Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Vollebregt Anne Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- van Dalen Thijs Department of Surgery, Diakonessen Hospital Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Smits A. Department of Surgery, St. Antonius Hospital, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Consten E. Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands aut NATIONALLICENCE 700 1- van Vroonhoven Theo Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Vriens Menno Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Borel Rinkes Inne Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1041-1046 1068-9265 18:4<1041 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer