Techniques of parathyroid exploration at North American endocrine surgery fellowship programs: what the next generation is being taught. Am J Surg 2014 Apr;207(4):527-32
Date
02/06/2014Pubmed ID
24495320DOI
10.1016/j.amjsurg.2013.05.012Scopus ID
2-s2.0-84896915496 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
BACKGROUND: Minimally invasive techniques are now often used to treat primary hyperparathyroidism but with uncertain conformity and some controversy. Endocrine surgery fellowships (ESFPs) have recently proliferated.
METHODS: The directors of the 19 ESFPs recognized by the American Association of Endocrine Surgeons were polled to identify the approaches currently taught to trainees.
RESULTS: With 100% participation, all ESFPs obtain ≥1 imaging study, and 95% use ultrasound to assess for concurrent thyroid nodules that require care. For an apparent single adenoma, all ESFPs minimize dissection, use intraoperative parathyroid hormone monitoring, and, if multiglandular disease is identified, perform 4-gland exploration. Outpatient surgery (89%) and postoperative oral calcium use (68%) are common. All programs define cure as durable normocalcemia (median, 6 months).
CONCLUSIONS: American Association of Endocrine Surgeons fellowship programs teach congruent management strategies that include focused dissection, intraoperative parathyroid hormone use, and intent to cure. These consistencies define a future standard for assessment of parathyroidectomy outcomes.
Author List
Wang TS, Pasieka JL, Carty SEAuthor
Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Education, Medical, ContinuingEndocrinology
Humans
Internship and Residency
Minimally Invasive Surgical Procedures
North America
Parathyroid Diseases
Parathyroidectomy
Program Development
Societies, Medical
