{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:02:46Z","timestamp":1770008566825,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>\nPreoperative imaging in patients undergoing surgery for primary hyperparathyroidism (PHPT) is used primarily to facilitate targeted parathyroidectomy. Failure of preoperative localisation mandates a bilateral exploration. It is thought that the results of imaging may also predict the success of surgery. The aims of this study were to assess whether the findings on preoperative localisation influenced outcomes following parathyroidectomy for PHPT and to explore factors underlying failure to cure at surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed outcomes of all patients who underwent first\u2010time surgery for PHPT in two centres over a 5\u2010year period to determine an association with demographic characteristics and findings on preoperative imaging. Records of patients not cured by initial surgery were reviewed to explore factors underlying failure to cure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The failure rate (persistent disease) in the entire cohort was 5 % (25\/541) (bilateral neck explorations, 5 %; unilateral exploration, 7 %; targeted approach, 4 %), while two patients developed recurrent disease. In patients who had undergone dual imaging with an ultrasound scan and <jats:sup>99m<\/jats:sup>Tc\u2010sestamibi scintigraphy, failure rates with \u201clateralised and concordant\u201d imaging, \u201cnonconcordant\u201d imaging, and \u201cdual\u2010negative\u201d imaging were 2, 9, and 11 %, respectively (<jats:italic>p<\/jats:italic> = 0.01). Of the 25 patients with persistent disease, multigland disease (MGD) was present in 52 % (13\/25) and ectopic adenoma in 24 % (6\/12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with PHPT who do not have lateralised and concordant dual imaging are at higher risk of persistent disease. A significant proportion of failures are due to the inability to recognise the presence and\/or extent of MGD.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2434-6","type":"journal-article","created":{"date-parts":[[2013,12,31]],"date-time":"2013-12-31T16:12:12Z","timestamp":1388506332000},"page":"534-541","source":"Crossref","is-referenced-by-count":37,"title":["Primary Hyperparathyroidism: An Analysis of Failure of Parathyroidectomy"],"prefix":"10.1002","volume":"38","author":[{"given":"A.","family":"Bagul","sequence":"first","affiliation":[{"name":"Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"},{"name":"Academic Unit of Surgical Oncology University of Sheffield Beech Hill Road S10 2RX Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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P.","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"University of Sheffield Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)60507\u20109"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpsurg.2010.08.002"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0011\u20103840(80)80006\u20102"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000186337.83407.ec"},{"issue":"4","key":"e_1_2_7_6_2","first-page":"263","article-title":"Primary hyperparathyroidism: diagnosis and management","volume":"33","author":"Body JJ","year":"2012","journal-title":"Rev Med Brux"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20109941\u20105"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.10.005"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200211000\u201000002"},{"key":"e_1_2_7_10_2","first-page":"245","article-title":"Therapeutisher versuch bein falls von ostitis fibrosa generalisatamittles. 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