{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:13:08Z","timestamp":1788243188260,"version":"build-2803163510"},"reference-count":40,"publisher":"International College of Surgeons","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>The aim of this study was to present our 20-year experience regarding primary hyperparathyroidism (PHPT). PHPT patients who underwent parathyroidectomy in our clinic were reviewed retrospectively. There were 190 PHPT patients, of whom 137 were asymptomatic (72%). The mean serum calcium at the time of diagnosis was 11.9 \u00b1 2.2 mg\/dL. The mean parathyroid hormone (PTH) level was 467 \u00b1 78 pg\/mL. Ultrasonography (USG) identified all abnormal glands accurately (82.6%) and Technetium-99m sestamibi scintigraphy (MIBI) was used in 89.4% of the patients and magnetic resonance imaging (MRI) in 61%. The common use of USG and MIBI detected 92% of the lesions. Bilateral neck exploration (BNE) was performed in 12.2% of the patients and focused unilateral neck exploration (FUNE) in the remaining 87.8%. Surgical intervention was unsuccessful in 1 patient (0.5%). The conversion ratio from FUNE to BNE was 5.2%. The mean operation time and mean hospital stay decreased significantly in patients with FUNE. Pathologic examination revealed single adenoma in 93% of the patients. New imaging techniques result in the conversion of surgical treatments of PHPT. FUNE in parathyroidectomy performed by an experienced surgeon may provide successful treatment rates.<\/jats:p>","DOI":"10.9738\/intsurg-d-14-00094.1","type":"journal-article","created":{"date-parts":[[2015,4,15]],"date-time":"2015-04-15T20:49:52Z","timestamp":1429130992000},"page":"648-655","source":"Crossref","is-referenced-by-count":18,"title":["A 20-Year Study on 190 Patients With Primary Hyperparathyroidism in a Developing Country: Turkey Experience"],"prefix":"10.9738","volume":"100","author":[{"given":"Arif","family":"Usta","sequence":"first","affiliation":[{"name":"Department of Surgery, State Hospital, Karab\u00fck, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etem","family":"Alhan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Karadeniz Technical University, Trabzon, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akif","family":"Cinel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Karadeniz Technical University, Trabzon, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"T\u00fcrky\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Karadeniz Technical University, Trabzon, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cihangir","family":"Erem","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Karadeniz Technical University, Trabzon, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4721","reference":[{"issue":"1","key":"i0020-8868-100-4-648-b01","series-title":"J Bone Miner Res","first-page":"171","article-title":"Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993\u20132001: an update on the changing epidemiology of the disease","volume":"21","author":"Wermers\n              RA,","year":"2006","unstructured":"Wermers\n              RA, \n            \n              Khosla\n              S, \n            \n              Atkinson\n              EJ.\n            \n          \n          Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993\u20132001: an update on the changing epidemiology of the disease. 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Surgery1947;21(3):394\u2013440"},{"issue":"1","key":"i0020-8868-100-4-648-b05","series-title":"Ther Apher Dial","first-page":"42","article-title":"Comparison between whole and intact parathyroid hormone assays","volume":"15","author":"Taniguchi\n              M,","year":"2011","unstructured":"Taniguchi\n              M, \n            \n              Tanaka\n              M, \n            \n              Hamano\n              T, \n            \n              Nakanishi\n              S.\n            \n          \n          Comparison between whole and intact parathyroid hormone assays. Ther Apher Dial2011;15(1):42\u201349"},{"issue":"16","key":"i0020-8868-100-4-648-b06","series-title":"AJR","first-page":"1706","article-title":"Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism","volume":"188","author":"Johnson\n              NA,","year":"2007","unstructured":"Johnson\n              NA, \n            \n              Tublin\n              ME, \n            \n              Ogilvie\n              JB.\n            \n          \n          Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. 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Clin Radiol2010;65(4):278\u2013287"},{"issue":"3","key":"i0020-8868-100-4-648-b08","series-title":"Maturitas","first-page":"246","article-title":"Primary hyperparathyroidism: skeletal and non-skeletal effects, diagnosis and management","volume":"70","author":"Pyram\n              R,","year":"2011","unstructured":"Pyram\n              R, \n            \n              Mahajan\n              G, \n            \n              Gliwa\n              A.\n            \n          \n          Primary hyperparathyroidism: skeletal and non-skeletal effects, diagnosis and management. 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Am J Surg2013;205(3):269\u2013273"},{"issue":"4","key":"i0020-8868-100-4-648-b13","series-title":"Surgery","first-page":"583","article-title":"Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy","volume":"138","author":"Chen\n              H,","year":"2005","unstructured":"Chen\n              H, \n            \n              Pruhs\n              Z, \n            \n              Starling\n              JR, \n            \n              Mack\n              E.\n            \n          \n          Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy. Surgery2005;138(4):583\u2013590"},{"issue":"7","key":"i0020-8868-100-4-648-b14","series-title":"Ann Surg Oncol","first-page":"2272","article-title":"Primary hyperparathyroidism and negative Tc99 sestamibi imaging: to operate or not?","volume":"19","author":"Dy\n              BM,","year":"2012","unstructured":"Dy\n              BM, \n            \n              Richards\n              ML, \n            \n              Vazquez\n              BJ, \n            \n              Thompson\n              GB, \n            \n              Farley\n              DR, \n            \n              Grant\n              CS.\n            \n          \n          Primary hyperparathyroidism and negative Tc99 sestamibi imaging: to operate or not?\n          Ann Surg Oncol\n          2012;19(7):2272\u20132278"},{"issue":"4","key":"i0020-8868-100-4-648-b15","series-title":"Ann R Coll Surg Engl","first-page":"290","article-title":"Simplified minimally invasive parathyroidectomy: a series of 100 cases and review of the literature","volume":"93","author":"Wong\n              W,","year":"2011","unstructured":"Wong\n              W, \n            \n              Foo\n              FJ, \n            \n              Lau\n              MI, \n            \n              Sarin\n              A, \n            \n              Kiruparan\n              P.\n            \n          \n          Simplified minimally invasive parathyroidectomy: a series of 100 cases and review of the literature. Ann R Coll Surg Engl2011;93(4):290\u2013293"},{"issue":"7","key":"i0020-8868-100-4-648-b16","series-title":"Int J Surg","first-page":"373","article-title":"Parathyroidectomy in a district general hospital: outcomes and evolution in the era of minimally invasive surgery","volume":"10","author":"Paravastu\n              SCV,","year":"2012","unstructured":"Paravastu\n              SCV, \n            \n              Chadwick\n              DR.\n            \n          \n          Parathyroidectomy in a district general hospital: outcomes and evolution in the era of minimally invasive surgery. Int J Surg2012;10(7):373\u2013377"},{"issue":"6","key":"i0020-8868-100-4-648-b17","series-title":"Surgery","first-page":"1008","article-title":"Is minimally invasive parathyroidectomy associated with greater recurrence compared to bilateral exploration? Analysis of more than 1,000 cases","volume":"152","author":"Schneider\n              DF,","year":"2012","unstructured":"Schneider\n              DF, \n            \n              Mazeh\n              H, \n            \n              Sippel\n              RS, \n            \n              Chen\n              H.\n            \n          \n          Is minimally invasive parathyroidectomy associated with greater recurrence compared to bilateral exploration? Analysis of more than 1,000 cases. 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Lancet2009;374(9684):145\u2013158"},{"key":"i0020-8868-100-4-648-b23","series-title":"Int J Endocrinol","first-page":"921814","article-title":"Systematic review of primary hyperparathyroidism in India: the past, present, and the future trends","volume":"2011","author":"Pradeep\n              PV,","year":"2011","unstructured":"Pradeep\n              PV, \n            \n              Jayashree\n              B, \n            \n              Mishra\n              A, \n            \n              Mishra\n              SK.\n            \n          \n          Systematic review of primary hyperparathyroidism in India: the past, present, and the future trends. Int J Endocrinol2011;2011:921814"},{"issue":"8","key":"i0020-8868-100-4-648-b24","series-title":"J Clin Endocrinol Metab","first-page":"2658","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\n              JA,","year":"1998","unstructured":"Sosa\n              JA, \n            \n              Powe\n              NR, \n            \n              Levine\n              MA, \n            \n              Udelsman\n              R, \n            \n              Zeiger\n              MA.\n            \n          \n          Profile of a clinical practice: thresholds for surgery and surgical outcomes for patients with primary hyperparathyroidism: a national survey of endocrine surgeons. 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Br J Surg2006;93(4):418\u2013421"},{"issue":"5","key":"i0020-8868-100-4-648-b36","series-title":"Langenbecks Arch Surg","first-page":"659","article-title":"Focused versus conventional parathyroidectomy for primary hyperparathyroidism: a prospective, randomized, blinded trial","volume":"393","author":"Slepavicius\n              A,","year":"2008","unstructured":"Slepavicius\n              A, \n            \n              Beisa\n              V, \n            \n              Janusonis\n              V, \n            \n              Strupas\n              K.\n            \n          \n          Focused versus conventional parathyroidectomy for primary hyperparathyroidism: a prospective, randomized, blinded trial. Langenbecks Arch Surg2008;393(5):659\u2013666"},{"issue":"1","key":"i0020-8868-100-4-648-b37","series-title":"Scand J Surg","first-page":"26","article-title":"Operation for primary hyperparathyroidism: the new versus the old order. A randomised controlled trial of preoperative localisation","volume":"96","author":"Aarum\n              S,","year":"2007","unstructured":"Aarum\n              S, \n            \n              Nordenstr\u00f6m\n              J, \n            \n              Reihn\u00e9r\n              E, \n            \n              Zedenius\n              J, \n            \n              Jacopsson\n              H, \n            \n              Danielsson\n              R\n            \n            et al\n          . Operation for primary hyperparathyroidism: the new versus the old order. A randomised controlled trial of preoperative localisation. 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Langenbecks Arch Surg2009;394(5):785\u2013798"},{"issue":"2","key":"i0020-8868-100-4-648-b39","series-title":"Nucl Med Rev East Eur","first-page":"153","article-title":"Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition: a case report","volume":"15","author":"Javadi\n              H,","year":"2012","unstructured":"Javadi\n              H, \n            \n              Jallalat\n              S, \n            \n              Semnani\n              S, \n            \n              Mogharrabi\n              M, \n            \n              Riazi\n              A, \n            \n              Nabipour\n              I\n            \n            et al\n          . Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition: a case report. Nucl Med Rev East Eur2012;15(2):153\u2013155"},{"issue":"3","key":"i0020-8868-100-4-648-b40","series-title":"Eur J Endocrinol","first-page":"45","article-title":"Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature","volume":"168","author":"Witteveen\n              JE,","year":"2013","unstructured":"Witteveen\n              JE, \n            \n              van Thiel\n              SV, \n            \n              Romijn\n              JA, \n            \n              Hamdy\n              NAT.\n            \n          \n          Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature. 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