{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T02:38:50Z","timestamp":1769999930785,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Two\u2010decades ago, the advent of sestamibi scintigraphy led to an enthusiastic acceptance of minimally invasive parathyroidectomy (MIP) in most surgical centres. More recently, concerns have been raised about the efficacy of limited neck exploration and some surgeons proposed bilateral neck exploration to be (once again) the gold standard operation for primary hyperparathyroidism in 2020s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A departmental database was used to identify patients who had MIP after concordant dual localisation with sestamibi scintigraphy and ultrasound scans. Long\u2010term follow\u2010up data were obtained from electronic patient records to ascertain any further treatment for recurrent disease and confirm most recent biochemical status. Patients with negative localisation scans and those with familial disease were excluded from analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between June 2001 and August 2014 a total of 404 patients (108\u00a0M:296F, median age 63 years, range 17\u201390 years) underwent MIP and had normalisation of calcium in first 6 weeks after the operation. Information on electronic patient records were missing in 14 patients; therefore, data on 390 patients were analysed. During median follow\u2010up of 78\u00a0months (IQR: 21.25\u2013111.75\u00a0months), 375 patients had normocalcaemia (2.36\u00a0mmol\/L, IQR: 2.29\u20132.44\u00a0mmol\/L) at a median 75\u00a0months, (IQR: 20\u2013118\u00a0months) after their operation. Overall, 15 (3.85%) patients had biochemical evidence of recurrent disease (2.70\u00a0mmol\/L IQR: 2.63\u20132.75\u00a0mmol\/L) at 92\u00a0months (Range: 6\u2013196) after initial operation. Of these, 5 (1.28%) patients underwent a second parathyroid procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recurrence after scan\u2010directed unilateral neck exploration occurred in 4% of patients after a long disease\u2010free interval. Only one patient had recurrent disease within 1\u2010year of primary surgery. The data suggest that bilateral neck exploration at the time of initial operation, in this selected cohort, is unlikely to have uncovered multi\u2010gland disease and prevent disease recurrence. Focused parathyroidectomy in patients with convincing localisation studies should continue.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06556-3","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T14:04:09Z","timestamp":1649772249000},"page":"2189-2194","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long\u2010term Cure of Primary Hyperparathyroidism After Scan\u2010Directed Parathyroidectomy: Outcomes From A UK Endocrine Surgery Unit"],"prefix":"10.1002","volume":"46","author":[{"given":"Neil","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Churchill Cancer Centre Oxford University Hospitals NHS Foundation Trust OX3 7LE Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radu","family":"Mihai","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Churchill Cancer Centre 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