Current trends in the surgical treatment of solitary parathyroid adenoma. A questionnaire study from 53 surgical departments in 14 countries

• Published in: The European journal of surgery Vol. 157; no. 2; p. 103
• Main Authors: Tibblin, S, Bondesson, A G, Udén, P
• Format: Journal Article
• Language: English
• Published: England 01.02.1991
• Subjects: Adenoma - surgery; Clinical Protocols; Humans; Hyperparathyroidism - surgery; North America; Parathyroid Neoplasms - surgery; Scandinavian and Nordic Countries; Surgery Department, Hospital; Surveys and Questionnaires; North America; Scandinavian and Nordic Countries
• ISSN: 1102-4151; 1741-9271

Current trends in the surgical treatment of primary hyperparathyroidism due to solitary parathyroid adenoma were evaluated in a questionnaire study. Response was obtained from 53 departments highly active in endocrine surgery in 14 countries (response rate 95%). Intraoperative histologic examination is widely (70%) regarded as necessary, but utilized more in North America and Scandinavia (87%) than elsewhere (45%). Intraoperative fat staining is used in one-third of the departments. Excisional biopsy including one whole gland is preferred by 32% to multiple incisional biopsies. Gross inspection of three normal parathyroid glands without histologic identification is favoured in 21% of the departments, while 31% prefer bilateral exploration and incisional biopsy. When an adenoma is found on the first side to be explored, 17% advocate bilateral exploration with incisional biopsy of all three normal glands, whereas unilateral exploration with excisional or incisional biopsy of the ipsilateral normal gland is preferred by a similar percentage.