AHNS Series: Do you know your guidelines? Optimizing outcomes in reoperative parathyroid surgery: Definitive multidisciplinary joint consensus guidelines of the American Head and Neck Society and the British Association of Endocrine and Thyroid Surgeons.
John C Morris, Gregory W Randolph, Geoffrey Thompson, David J Terris, David L Steward, David Scott-Coombes, John A Ridge, Fausto Palazzo, Lisa Ann Orloff, Brendan C Stack, James E Jackson, Henning Dralle, Jeremy P D T Cox, Pauline Camacho, Donald Bodenner, John P Bilezikian, Twyla B Bartel, Neil S Tolley
Journal: Head & neck
2019;40(8):1617-1629
PMID: 30070413
Abstract
BACKGROUND
Revision parathyroid is challenging due to possible diagnostic uncertainty as well as the technical challenges it can present.
METHODS
A multidisciplinary panel of distinguished experts from the American Head and Neck Society (AHNS) Endocrine Section, the British Association of Endocrine and Thyroid Surgeons (BAETS), and other invited experts have reviewed this topic with the purpose of making recommendations based on current best evidence. The literature was also reviewed on May 12, 2017. PubMed (1946-2017), Cochrane SR (2005-2017), CT databases (1997-2017), and Web of Science (1945-2017) were searched with the following strategy: revision and reoperative parathyroidectomy to ensure completeness.
RESULTS
Guideline recommendations were made in 3 domains: preoperative evaluation, surgical management, and alternatives to surgery. Eleven guideline recommendations are proposed.
CONCLUSION
Reoperative parathyroid surgery is best avoided if possible. Our literature search and subsequent recommendations found that these cases are best managed by experienced surgeons using precision preoperative localization, intraoperative parathyroid hormone (PTH), and the team approach.
© 2018 Wiley Periodicals, Inc.
Address:
Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.; Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, UK.; Global Advanced Imaging, PLLC, Little Rock, Arkansas.; Department of Medicine, Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, New York.; Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.; Department of Medicine, Division of Endocrinology, Loyola University, Chicago, Illinois.; Department of Metabolic Medicine, Imperial College Hospital, NHS Healthcare Trust, London, UK.; Sektion Endokrine Chirurgie, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Medizinisches Zentrum, Germany.; Department of Imaging, Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, UK.; Department of Medicine, Division of Endocrinology, Mayo Clinic, Rochester, Minnesota.; Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, California.; Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.; Department of Surgery, Cardiff and Vale Hospitals, Wales, UK.; Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio.; Department of Otolaryngology - Head and Neck Surgery, Augusta University, Augusta, Georgia.; Department of Surgery, Mayo Clinic, Rochester, Minnesota.; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard University, Boston, Massachusetts.
Link outs
Free resources
Other Literature Sources:
Research Materials:
Subscription / membership required
MeSH Terms:
Bone Density,
Calcium,
Cholecalciferol,
Clinical Competence,
Diagnosis, Differential,
Hospitals, High-Volume,
Humans,
Hyperparathyroidism, Primary,
Intraoperative Neurophysiological Monitoring,
Medical History Taking,
Parathyroid Glands,
Parathyroidectomy,
Patient Selection,
Postoperative Complications,
Preoperative Care,
Recurrence,
Reoperation,
Societies, Medical,
Vitamin D Deficiency,
Vitamins