{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:49:10Z","timestamp":1761896950538,"version":"3.37.3"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T00:00:00Z","timestamp":1551916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T00:00:00Z","timestamp":1551916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A positive and concordant result of at least two diagnostic modalities is generally recommended prior to focused parathyroidectomy. The aim of this study was to analyze the results of surgery and the accurateness of preoperative ultrasonography (US) as single localization modality in patients who underwent parathyroidectomy without the adjunct of intraoperative Parathormone (PTH) measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The cases with a preoperative US as the only localization technique, who underwent parathyroidectomy between 10\/1999 and 12\/2017, were selected from a prospectively maintained database. Therefore, a total number of 242 patients with a mean age of 58.6\u2009\u00b1\u200913.7 years were included in the present study. US was performed by referral endocrinologist or by the surgeon during office visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall \u201ccure rate\u201d was 99.2% (240 out of 242 patients). In 228\/242 patients (94.2%), a drop of perioperative PTH levels consistent with the definition of cure was observed on the day of surgery. In four of the remaining 14 patients, healing was confirmed by PTH level dropping into the normal range on the first postoperative day. Eight patients were cured after a reoperation was performed at our department. Postoperative complications included one case of permanent recurrent laryngeal nerve palsy (0.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>If performed by an experienced endocrinologist and\/or endocrine surgeon, a positive US could be the only preoperative localization study in patients with pHPT. Moreover, the add\u2010value of intraoperative PTH is limited. Major advantages of US are a very high accuracy, the ease of performance (accessibility) and its cost\u2010effectiveness compared with Sesta\u2010MIBI scintigraphy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-04944-w","type":"journal-article","created":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T20:15:12Z","timestamp":1551989712000},"page":"1525-1531","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Minimally Invasive Parathyroidectomy without Intraoperative PTH Performed after Positive Ultrasonography as the only Diagnostic Method in Patients with Primary Hyperparathyroidism"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-4962","authenticated-orcid":false,"given":"Ralph","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of Surgery and Center for Minimal Invasive Surgery Kliniken Essen\u2010Mitte Henricistra\u00dfe 92 45136 Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob","family":"Hinrichs","sequence":"additional","affiliation":[{"name":"Department of Surgery and Center for Minimal Invasive Surgery Kliniken Essen\u2010Mitte Henricistra\u00dfe 92 45136 Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beate","family":"Meier","sequence":"additional","affiliation":[{"name":"Department of Surgery and Center for Minimal Invasive Surgery Kliniken Essen\u2010Mitte Henricistra\u00dfe 92 45136 Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin K.","family":"Walz","sequence":"additional","affiliation":[{"name":"Department of Surgery and Center for Minimal Invasive Surgery Kliniken Essen\u2010Mitte Henricistra\u00dfe 92 45136 Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pier Francesco","family":"Alesina","sequence":"additional","affiliation":[{"name":"Department of Surgery and Center for Minimal Invasive Surgery Kliniken Essen\u2010Mitte Henricistra\u00dfe 92 45136 Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,7]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"485","article-title":"Primary hyperparathyroidism: incidence and clinical and biochemical characteristics. 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