caa a22 4500 475803620 CHVBK 20180406123744.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010220 doi (NATIONALLICENCE)springer-10.1007/s002680010220 Supernumerary Parathyroid Glands: Frequency and Surgical Significance in Treatment of Renal Hyperparathyroidism [Elektronische Daten] [François N. Pattou, Laurent C. Pellissier, Christian Noël, François Wambergue, Damien G. Huglo, Charles A.G. Proye] Supernumerary parathyroid glands (SPGs) are found in 13% of random autopsies. The high incidence of SPGs could explain the persistence or trigger recurrence of renal hyperparathyroidism after surgery. The aim of this study was to assess the frequency and clinical relevance of SPG in patients operated on for renal hyperparathyroidism (HPT). In this retrospective study we reviewed the medical records of 290 patients with renal HPT who were initially treated in our department. We examined the anatomic and pathologic findings during cervical surgical exploration and the outcome of HPT during follow-up. SPGs were identified in 87 patients (30%) during the initial cervicotomy, corresponding to intrathymic parathyroid cell islets (one to four) in 70 cases and to extrathymic SPG in 17 patients. Among 260 patients available for follow-up, 11 experienced persistent HPT (4%), and 34 developed recurrent HPT (13%). A total of 25 patients were reoperated on, and SPGs were responsible for 4 of 8 cases of persistent HPT and 4 of 17 cases of recurrent HPT, representing an overall frequency of 32%. The anatomic distribution of SPGs found during reoperations included thymus, retroesophageal grove, carotid sheath, and mediastinum. SPGs are thus present in 30% of patients with renal HPT and are situated mainly in the thymus. Thymectomy should be performed routinely during the first surgical exploration to prevent recurrences arising from anterior mediastinal glands. SPGs were also responsible for 32% of persistent or recurrent HPT. In that setting, frankly ectopic SPGs are not rare, and preoperative imaging appears highly desirable prior to embarking on surgical reexploration. Société Internationale de Chirurgie, 2000 Pattou François N. Department of General and Endocrine Surgery, University Hospital, 59037 Lille, France, FR aut Pellissier Laurent C. Department of General and Endocrine Surgery, University Hospital, 59037 Lille, France, FR aut Noël Christian Department of Medicine and Nephrology, University Hospital, 59037 Lille, France, FR aut Wambergue François Department of Medicine and Nephrology, Clinique du Bois, Lambersart, Avenue de Dunkerque, 59037 Lille, France, FR aut Huglo Damien G. Department of Nuclear Medicine, University Hospital, 59037 Lille, France, FR aut Proye Charles A.G. Department of General and Endocrine Surgery, University Hospital, 59037 Lille, France, FR aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1330-1334 0364-2313 24:11<1330 2000 24 268 https://doi.org/10.1007/s002680010220 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010220 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pattou François N. Department of General and Endocrine Surgery, University Hospital, 59037 Lille, France, FR aut NATIONALLICENCE 700 1- Pellissier Laurent C. Department of General and Endocrine Surgery, University Hospital, 59037 Lille, France, FR aut NATIONALLICENCE 700 1- Noël Christian Department of Medicine and Nephrology, University Hospital, 59037 Lille, France, FR aut NATIONALLICENCE 700 1- Wambergue François Department of Medicine and Nephrology, Clinique du Bois, Lambersart, Avenue de Dunkerque, 59037 Lille, France, FR aut NATIONALLICENCE 700 1- Huglo Damien G. Department of Nuclear Medicine, University Hospital, 59037 Lille, France, FR aut NATIONALLICENCE 700 1- Proye Charles A.G. Department of General and Endocrine Surgery, University Hospital, 59037 Lille, France, FR aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1330-1334 0364-2313 24:11<1330 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer