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Warnings Of Lower Cure Rates, Longer Follow-up For One-Side Parathyroid Surgery

Tue, 05/29/2012 - 6:19am

(PRNewswire) Dr. Douglas Politz, MD, one of the world's most experienced parathyroid surgeons, presented at the annual meeting of the American Association of Clinical Endocrinology this past weekend. His findings showed that one-side mini-parathyroid surgery does not live up to the hype it has been given over the past decade. In a dramatic about face, Dr. Politz and his colleagues at the Norman Parathyroid Center, who have been advocates of unilateral or one-side parathyroid surgery, presented long-term data showing cure rates are substantially lower for the smaller operation.

"Our group is credited with developing the methodology and techniques used in mini-parathyroid surgery," stated Dr. Politz. "We were very strong advocates of the smaller one-side operation for years. However, 18-year followup in 16,500 patients shows that cure rates are not what we had hoped and at least 12 percent will need a second parathyroid operation within 10 years. These findings have caused us to abandon one-side parathyroid surgery."

We were honored to be chosen to present our data to our endocrinology colleagues," stated Dr. James Norman, a co-author on the paper. "Surgeons need to stop hyping one-side parathyroid surgery. We all need to stop getting so many scans and do what is best for the patients. Fortunately, we have developed the means to evaluate all four parathyroid glands in less than 20 minutes in almost all patients."

The take home message for practicing endocrinologists is to know how many parathyroid glands the surgeon evaluated. If all four were assessed, then the patient can be presumed cured and long-term followup is not necessary. If all four parathyroid glands were not assessed, then that patient must be seen annually forever. According the Politz, the choice is very clear and patients should expect that parathyroid glands on both sides of the neck are assessed during parathyroid surgery.

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