{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:56:23Z","timestamp":1791050183519,"version":"4.1.0"},"reference-count":23,"publisher":"Royal College of Surgeons of England","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> Parathyroidectomy is considered to be a safe procedure with low morbidity. However, while this is true for primary hyperparathyroidism, whether it applies to tertiary disease is not so well documented. The aim of this study was to assess the morbidity of surgery for tertiary hyperparathyroidism compared with primary disease and to establish whether there are predictive factors for poor outcomes. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Data for patients subjected to parathyroidectomy during the period 2007\u20132015 were retrospectively analysed from a prospectively collected database. Patient age, sex, American Society of Anesthesiologists (ASA) score, renal status, extent of operation and indications for surgery were examined. The complication and mortality rate were compared and independent predictors of outcome were examined. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 1079 patients were scheduled for a parathyroidectomy during the study period of whom 158 for renal related hyperparathyroidism (renal group) and 921 for primary disease (non-renal group). There was a significantly higher complication rate in the renal parathyroid group, including a higher mortality (1.3% vs 0.1%, P = 0.011), overall complication rate (7.0% vs 2.3%, P = 0.001), surgery related complication rate (4.4% vs 1.7%, P = 0.03) and systemic complication rate (2.5% vs 0.4%, P = 0.005). In patients with ASA score \u2264 2 reoperative surgery (OR 9.25, 95% confidence interval, CI 1.41\u201360.75), male sex (OR 4.12, 95% CI 1.46\u201311.63) and renal impairment were (OR 5.86, 95% CI 1.65\u201320.78) were predictors of worse outcomes. In patients with ASA score \u22653 renal impairment, in addition to other variables, were not predictors of complications. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Parathyroidectomy in renal-related disease is associated with a significantly higher risk of morbidity and mortality compared with primary hyperparathyroidism. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2018.0032","type":"journal-article","created":{"date-parts":[[2018,6,30]],"date-time":"2018-06-30T18:03:32Z","timestamp":1530381812000},"page":"436-442","source":"Crossref","is-referenced-by-count":8,"title":["Morbidity in parathyroid surgery for renal disease is under reported: a comparison of outcomes with primary hyperparathyroidism"],"prefix":"10.1308","volume":"100","author":[{"given":"K","family":"Nastos","sequence":"first","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Constantinides","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Mizamtsidi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Tolley","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Palazzo","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2004.02.020"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20740"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-1763"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-009-0510-z"},{"issue":"4","key":"bib5","first-page":"S1","volume":"42","year":"2003","journal-title":"Am J Kidney 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