{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:52:42Z","timestamp":1792432362883,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with renal hyperparathyroidism undergoing parathyroidectomy may experience relapse. Reoperation for persistent or recurrent disease, particularly in the neck region, is challenging and has a high complication rate because of difficult exploration. We aimed to evaluate the effectiveness of neck reoperation in renal hyperparathyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with recurrent or persistent renal hyperparathyroidism who underwent neck reoperation between January 2015 and August 2022 were investigated, focusing on operative findings, perioperative biochemical changes, and significance of intraoperative parathyroid hormone (PTH) measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During reoperation, 35 parathyroid glands were identified and removed from the 26 enrolled patients, with one, two, and three glands retrieved from 19 (73.2%), five (19.2%), and two (7.6%) patients, respectively. Most removed glands (68.6%) were located in the lower neck, followed by the mediastinum, carotid sheath, and upper neck. Successful resection, defined as a postoperative PTH level of\u2009&lt;300 pg\/mL, was achieved in 21 patients (80.8%). The remaining four (15.4%) and one (3.9%) patients were classified as having persistent and recurrent disease, respectively. The extent of PTH reduction was correlated with specimen weight, specimen volume, and preoperative alkaline phosphatase (ALP) level. The mean intraoperative PTH ratio (10\u00a0min after excision\/pre\u2010excision) was 0.23, and all patients with persistent or recurrent disease had a PTH ratio\u2009&gt;0.3. Severe hypocalcemia (&lt;7.5\u00a0mg\/dL) occurred in 19 (73.0%) patients after reoperation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neck reoperation is an effective therapeutic option in patients with recurrent or persistent renal hyperparathyroidism. A decrease in PTH level by\u2009&gt;70% during reoperation (PTH ratio\u2009&lt;0.3) predicts successful resection.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07172-5","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T19:07:53Z","timestamp":1694804873000},"page":"2784-2791","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Neck Reoperation for Recurrent or Persistent Renal Hyperparathyroidism"],"prefix":"10.1002","volume":"47","author":[{"given":"Lu\u2010Chia","family":"Chang","sequence":"first","affiliation":[{"name":"Division of General Surgery Department of Surgery Kaohsiung Veterans General Hospital Zuoying District, No. 386, Dazhong 1st Rd. 813414 Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiuh\u2010Inn","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of General Surgery Department of Surgery Kaohsiung Veterans General Hospital Zuoying District, No. 386, Dazhong 1st Rd. 813414 Kaohsiung Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University No.155, Sec. 2, Linong Street 112304 Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4005-7661","authenticated-orcid":false,"given":"Tsung\u2010Jung","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of General Surgery Department of Surgery Kaohsiung Veterans General Hospital Zuoying District, No. 386, Dazhong 1st Rd. 813414 Kaohsiung Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University No.155, Sec. 2, Linong Street 112304 Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"e_1_2_7_2_1","article-title":"Secondary hyperparathyroidism: recurrence after total parathyroidectomy with autotransplantation","volume":"149","author":"Steffen L","year":"2019","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfz112"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005522"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.04.006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.72"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.27432"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010006\u20100391\u2010z"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010010\u20100412\u20109"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010002\u20100322\u2010x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010010\u20100446\u2010z"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2000.105865"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs\u201020\u2010391"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200201000\u201000013"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010011\u20101776\u20107"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010198603000\u201000011"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010009\u20101313\u20108"},{"key":"e_1_2_7_18_1","first-page":"1690","article-title":"A simple formula to estimate parathyroid weight on 4D\u2010CT, predict pathologic weight, and diagnose parathyroid adenoma in patients with primary hyperparathyroidism","volume":"41","author":"Yeh R","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101560\u2010x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882\u2010016\u20100421\u20105"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.05.024"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010006\u20100070\u20104"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010002\u20106731\u20108"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102091\u20109"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.139.12.1331"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611\u2010199503000\u201000016"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.142.4.381"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010004\u20107321\u20108"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6613659"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109787\u20102"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07172-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-023-07172-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07172-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-023-07172-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T10:48:31Z","timestamp":1719226111000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-023-07172-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,15]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1007\/s00268-023-07172-5"],"URL":"https:\/\/doi.org\/10.1007\/s00268-023-07172-5","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,15]]},"assertion":[{"value":"30 July 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All the authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}