{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:51:55Z","timestamp":1784739115341,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2002,3,19]],"date-time":"2002-03-19T00:00:00Z","timestamp":1016496000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2002,3]]},"abstract":"<jats:p> <jats:bold>Background<\/jats:bold>: Parathyroidectomy has long been established as an effective treatment for primary hyperparathyroidism (HPT).<\/jats:p><jats:p> <jats:bold>Methods<\/jats:bold>: A 15\u2010year retrospective audit was made by surgeons at North Shore Hospital, Auckland, of 33 patients with primary HPT who had parathyroidectomy.<\/jats:p><jats:p> <jats:bold>Results<\/jats:bold>: There were 22 females and 11 males, ranging in age from 18 to 77 years (median 63 years). Initial diagnosis was predominantly by a general practitioner (72%), who invariably referred to a physician. Referral to surgery was made by general physicians (55%), endocrinologists (33%) and geriatricians (6%). Delay between diagnosis and referral for surgery ranged from 8 days to 10 years (median 7 months), and exceeded 2 years in 24% of patients. Twenty\u2010eight (85%) were symptomatic: 13 (39%) had renal symptoms, 13 (39%) had bone disease, 10 (31%) had gastrointestinal complaints, seven (21%) had psychiatric illnesses and six (18%) had fatigue. The high incidence of symptoms was matched by high biochemical values (mean serum cal\u2010 cium level 2.97 mmol\/L), and large parathyroid glands (mean weight 2001 mg). Twenty\u2010nine patients (88%) had single adenomas, two (6%) had chief cell hyperplasia and two (6%) had carcinoma. Thirty\u2010one (94%) were cured of their primary HPT.<\/jats:p><jats:p> <jats:bold>Conclusions<\/jats:bold>: Parathyroidectomy is a safe and effective treatment for primary HPT but depends upon referral from non\u2010surgical clinicians. A large proportion of patients have long delays before their surgery, and the group selected for surgery is referred with severe disease.<\/jats:p>","DOI":"10.1046\/j.1445-2197.2002.02343.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T02:48:29Z","timestamp":1047350909000},"page":"200-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Primary hyperparathyroidism: Referral patterns and outcomes of surgery"],"prefix":"10.1111","volume":"72","author":[{"given":"Richard S.","family":"Flint","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Richard","family":"Harman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Carter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerrie","family":"Snyman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,3,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.2000.01817.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"crossref","unstructured":"MeltonLJ.Epidemiology of primary hyperparathyroidism.J. 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Gynaecol."},{"key":"e_1_2_6_21_2","first-page":"1","article-title":"Akerstrom G, Ljunghall S. Mortality after surgery for primary hyperparathyroidism: A follow\u2010up of 441 patients operated on from. to 1979.","volume":"102","author":"Palmer M","year":"1956","journal-title":"Surgery"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01658740"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(05)80076-5"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(96)80039-0"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(98)00016-7"},{"key":"e_1_2_6_26_2","doi-asserted-by":"crossref","first-page":"2658","DOI":"10.1210\/jcem.83.8.5006","article-title":"Profile of a clinical practice: Thresholds for surgery and surgical outcomes for patients with primary hyperparathyroidism: A national survey of endocrine surgeons.","volume":"83","author":"Sosa JA","year":"1998","journal-title":"J. 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