{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:53:03Z","timestamp":1777938783150,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2007,3,1]],"date-time":"2007-03-01T00:00:00Z","timestamp":1172707200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>In patients with primary hyperparathyroidism (PHPT), parathyroid imaging is nowadays routinely used for the purpose to perform a focused unilateral minimally invasive operation. The outcome of this new strategy has, however, not been established in randomised trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>Patients were randomised to either preoperative localisation with sestamibi scintigraphy and ultrasonography (group I) or no preoperative localisation (group II). In group I, a minimally invasive parathyroidectomy was performed in patients in whom both localisation studies were consistent with a single pathological gland, whereas a conventional bilateral neck exploration was performed in cases with negative localisation findings. In group II all patients underwent conventional bilateral neck exploration. Primary outcome measure was normocalcaemia at 6 months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In the preoperative localisation group (group I) 23\/50 (46%) of the patients could be operated on with the focused operation whereas 26\/50 (52%) were operated on by bilateral neck exploration. All patients in the no localisation group (group II; n=50) were operated on with the intended bilateral neck operation. Normocalcaemia was obtained in 96% and 94% in group I and II, respectively. Total (localisation and operative) costs were 21% higher in group I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Routine preoperative localisation, with the intention to perform minimally invasive parathyroidectomy, is not cost effective if concordant results of scintigraphy and ultrasonography are a prerequisite for the focused operation. Less than half of the patients were successfully managed with this strategy, at a higher cost and without obtaining a more favourable clinical outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/145749690709600105","type":"journal-article","created":{"date-parts":[[2017,1,10]],"date-time":"2017-01-10T22:28:47Z","timestamp":1484087327000},"page":"26-30","source":"Crossref","is-referenced-by-count":26,"title":["Operation for Primary Hyperparathyroidism: The New versus the Old Order"],"prefix":"10.1177","volume":"96","author":[{"given":"S.","family":"Aarum","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Nordenstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Reihn\u00e9r","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Zedenius","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Diagnostic Radiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Danielsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Section of Diagnostic Radiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"B\u00e4ckdahl","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Lindholm","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Diagnostic Radiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, 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