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Risk factors of redo surgery after unilateral focused parathyroidectomy: Conclusions from a comprehensive nationwide database of 13,247 interventions over 6 years

Annals of Surgery Nov 26, 2020

Donatini G, Marciniak C, Lenne X, et al. - As the definitive treatment for primary hyperparathyroidism (pHPT) is the surgical removal of the hyperfunctional parathyroid gland, researchers conducted a nationwide retrospective cohort study to assess the incidence of redo surgery following targeted parathyroidectomy for pHPT. This investigation was performed on the “Programme de Medicalisation des Systemes d’Information,” the French administrative database that collects information on all healthcare facilities’ discharges. Data were collected from 2009 to 2018 for all patients undergoing parathyroidectomy for pHPT between January 2011 and December 2016. Thirteen thousand two hundred forty-seven patients (median age 63, F/M = 3.6) had a focused parathyroidectomy by open (88.7%) or endoscopic approach during the study period. While focused parathyroidectomy represents a standardized operation, the rate of cure is closely correlated with the annual hospital caseload, type of procedure (endoscopic), and characteristics of patients (obesity, cardiac history). In a high volume center, patients with risk factors for redo surgery should be considered for open surgery.

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