1,596 results match your criteria Minimally Invasive Surgery of the Parathyroid


Efficacy and safety of radiofrequency ablation versus parathyroidectomy for secondary hyperparathyroidism in dialysis patients: a single-center retrospective study.

Sci Rep 2022 Jun 18;12(1):10289. Epub 2022 Jun 18.

Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.

We compared the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) and parathyroidectomy (PTX) for the treatment of secondary hyperparathyroidism (SHPT). In this single-center retrospective study, we divided patients into PTX (n = 53) and RFA (n = 47) groups. The primary outcome was the proportion of patients who achieved the target intact parathyroid hormone (iPTH) concentration range (≤ 300 pg/mL). Read More

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Indocyanine green (ICG) fluorescence guide for the use and indications in general surgery: recommendations based on the descriptive review of the literature and the analysis of experience.

Cir Esp (Engl Ed) 2022 Jun 11. Epub 2022 Jun 11.

Unit of Innovation in Minimally Invasive Surgery, Department of General and Digestive Surgery, University Hospital Virgen del Rocio, University of Sevilla, Sevilla, Spain; UOC of General and Minimally Invasive Surgery, Hospital "San Paolo", Civitavecchia, Rome, Italy. Electronic address:

Indocyanine Green is a fluorescent substance visible in near-infrared light. It is useful for the identification of anatomical structures (biliary tract, ureters, parathyroid, thoracic duct), the tissues vascularization (anastomosis in colorectal, esophageal, gastric, bariatric surgery, for plasties and flaps in abdominal wall surgery, liver resection, in strangulated hernias and in intestinal ischemia), for tumor identification (liver, pancreas, adrenal glands, implants of peritoneal carcinomatosis, retroperitoneal tumors and lymphomas) and sentinel node identification and lymphatic mapping in malignant tumors (stomach, breast, colon, rectum, esophagus and skin cancer). The evidence is very encouraging, although standardization of its use and randomized studies with higher number of patients are required to obtain definitive conclusions on its use in general surgery. Read More

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Flexible single port access in transoral endoscopic thyroidectomy vestibular approach.

Gland Surg 2022 May;11(5):778-787

Department of Surgery, Saint John of God (SJOG) Hospital, Salzburg, Austria.

Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is regarded the only no-scar technique which combines minimized surgical trauma with all advantages of endoscopy such as enhanced view, fluorescent parathyroid imaging (FPI) and optimum cosmesis. Addressing TOETVA specific local risk profiles like mental nerve injury, the potential of skin lesions or difficult specimen retrieval we modified the three trocar based TOETVA towards a soft single port platform.

Methods: Single port-TOETVA (SP-TOETVA) was established and retrospectively analysed in five patients using a soft handmade single port housing multiple trocar valves. Read More

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Minimally Invasive Techniques for the Management of Thyroid Nodules.

Endocrinol Metab Clin North Am 2022 Jun;51(2):323-349

Department of Medicine, Diabetes and Endocrinology Section, New York University School of Medicine, 222 East, 41st Street, Floor 23, NY 10016, USA.

Image-guided interventional techniques have emerged as promising treatments for thyroid disease. Percutaneous ethanol ablation, radiofrequency ablation, laser ablation, high intensity focused ultrasound, and microwave ablation have shown efficacy in treating benign thyroid disease. There is increasing evidence that these techniques may effectively treat papillary thyroid microcarcinomas, recurrent and metastatic disease, follicular neoplasms, and parathyroid lesions. Read More

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Conversion rates in robotic thyroid surgery: A systematic review and meta-analysis.

Int J Med Robot 2022 May 29:e2427. Epub 2022 May 29.

Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy.

Objective: To define the conversion risk to open procedure during robot-assisted thyroid surgery (RATS) identifying potential specific subclasses of procedures or accesses at higher conversion risk.

Methods: In a PRISMA-compliant framework, all original prospective studies providing RATS conversion rates from multiple databases were pooled in a random-effects meta-analysis. Conversion rates were compared between different typologies of thyroid surgery and robotic access. Read More

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Preoperative Imaging with [F]-Fluorocholine PET/CT in Primary Hyperparathyroidism.

J Clin Med 2022 May 23;11(10). Epub 2022 May 23.

Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany.

Primary hyperparathyroidism (pHPT) is a common endocrine disorder due to hyperfunctioning parathyroid glands. To date, the only curing therapy is surgical removal of the dysfunctional gland, making correct detection and localization crucial in order to perform a minimally invasive parathyroidectomy. F-Fluorocholine positron emission tomography/computed tomography (F-FCH PET/CT) has shown promising results for the detection of pHPT, suggesting superiority over conventional imaging with ultrasounds or scintigraphy. Read More

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Minimally invasive video-assisted parathyroidectomy (MIVAP) versus conventional parathyroidectomy for renal hyperparathyroidism: a retrospective multicenter study.

Updates Surg 2022 May 25. Epub 2022 May 25.

Klinik Für Endokrine Chirurgie, Helios University Hospital Wuppertal, Wuppertal, Germany.

To compare minimally invasive video-assisted parathyroidectomy (MIVAP) versus conventional surgery for renal hyperparathyroidism (rHPT). Between 2006 and 2020, 53 patients underwent MIVAP and 182 underwent conventional parathyroidectomy for rHPT at the Kliniken Essen-Mitte and Knappschaftskrankenhaus Bochum, respectively. Two propensity score-matched groups were retrospectively analyzed: the MIVAP group (VG; n = 53) and the conventional group (CG; n = 53). Read More

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Improving Voice Outcomes after Thyroid Surgery and Ultrasound-Guided Ablation Procedures.

Front Surg 2022 4;9:882594. Epub 2022 May 4.

Sarasota Memorial Health Care System Multidisciplinary Thyroid and Parathyroid Center, Sarasota, Florida, United States.

The field of endocrine surgery has expanded from the traditional open neck approach to include remote access techniques as well as minimally invasive approaches for benign and malignant thyroid nodules. In experienced hands and with careful patient selection, each approach is considered safe, however complications can and do exist. Post-operative dysphonia can have serious consequences to the patient by affecting quality of life and ability to function at work and in daily life. Read More

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Detection of an undescended parathyroid adenoma with F-fluorocholine PET/CT.

Eur J Hybrid Imaging 2022 May 17;6(1):10. Epub 2022 May 17.

Department of Surgery, Flevoziekenhuis, Almere, The Netherlands.

Surgical excision of a parathyroid adenoma (PTA) is the only curative treatment for primary hyperparathyroidism (PHP). The transition from routine bilateral neck exploration to minimally invasive parathyroidectomy has been made possible by preoperative location techniques, including molecular imaging. Here, we present a case of a 76-year-old man with PHP who underwent a [F]fluorocholine PET/CT scan, which showed a rare undescended PTA at the level of the right carotid bifurcation. Read More

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Evolution of transoral endoscopic thyroidectomy vestibular approach according to the IDEAL framework.

Br J Surg 2022 May;109(6):497-502

Department of Otolaryngology-Head and Neck Surgery, Royal Berkshire Hospital, Reading, UK.

Background: The IDEAL Framework is a scheme for safe implementation and assessment of surgical innovation. The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a new innovation in thyroid surgery that eliminates the need for a cervical incision. Despite considerable interest and adoption worldwide, significant scepticism remains regarding the outcomes and cost-effectiveness for healthcare systems. Read More

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Minimally Invasive Parathyroidectomy in a Child With Acute Pancreatitis.

Cureus 2022 Apr 12;14(4):e24058. Epub 2022 Apr 12.

Clinical Surgical Sciences, University of the West Indies, St. Augustine, TTO.

Acute pancreatitis (AP) is rarely seen in the paediatric population and is typically not associated with those aetiologies seen in adult pancreatitis. This case describes a 12-year-old female who presented with acute abdominal pain and constipation, with biochemical evidence of elevated serum amylase, calcium (Ca) and parathyroid hormone (PTH) levels. A diagnosis of AP was made, which was settled with conservative management. Read More

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Surgical treatment of thyroid cancer: Established and novel approaches.

Best Pract Res Clin Endocrinol Metab 2022 Apr 29:101664. Epub 2022 Apr 29.

Sarasota Memorial Health Care System Multidisciplinary Thyroid and Parathyroid Center, 1901 Floyd St., Ste.304, Sarasota, 34239, Florida, USA. Electronic address:

Thyroid surgery is one of the most common head and neck procedures. The thyroid can be accessed through an anterior cervical incision, or by remote access techniques such as the transoral endoscopic thyroidectomy vestibular approach (TOETVA) which is favored for its ease, safety and direct plane to the thyroid gland. Other novel approaches for targeting small-localized well-differentiated thyroid cancer are by thermal ablation, namely ultrasound guided radiofrequency ablation. Read More

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Parathyroid Computed Tomography: Pearls, Pitfalls, and Our Approach.

Neuroimaging Clin N Am 2022 May;32(2):413-431

Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, USA.

Parathyroid imaging is predominantly used for preoperative localization of parathyroid lesions in patients with the biochemical diagnosis of primary hyperparathyroidism. Although imaging algorithms vary, in the era of minimally invasive parathyroidectomy for single parathyroid adenomas, multiphase parathyroid computed tomography (CT) (4-dimensional CT) has emerged as a favored modality for presurgical mapping of parathyroid lesions. Implementation and correct interpretation of these studies can be challenging, although confidence and accuracy improve with experience and volume. Read More

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Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study.

Korean J Radiol 2022 05;23(5):555-565

Department of Graduate, Bengbu Medical College, Bengbu, China.

Objective: To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT).

Materials And Methods: This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15. Read More

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A scoping review of approaches used for remote-access parathyroidectomy: A contemporary review of techniques, tools, pros and cons.

Head Neck 2022 Apr 25. Epub 2022 Apr 25.

Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.

After our coauthors described the first remote-access parathyroidectomy (RAP) series in 2000, several other approaches were developed. No systematic review has been performed to classify and evaluate RAP techniques. We performed a literature search using PubMed and Cochrane Library (CENTRAL). Read More

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Diagnostic Performance of F-Choline Positron Emission Tomography/Contrast-Enhanced Computed Tomography in Adenoma Detection in Primary Hyperparathyroidism after Inconclusive Imaging: A Retrospective Study of 215 Patients.

Cancers (Basel) 2022 Apr 17;14(8). Epub 2022 Apr 17.

Service de Chirurgie Endocrinienne, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France.

This large, retrospective, single-centre study evaluated the diagnostic performance of F-choline positron emission tomography/contrast-enhanced computed tomography (PET/ceCT) in preoperative parathyroid adenoma detection in primary hyperparathyroidism cases after negative/inconclusive ultrasound or other imaging findings. We included patients who underwent surgery and F-choline PET/ceCT for inconclusive imaging results between 2015 and 2020. We compared the F-choline PET/ceCT results with surgical and histopathological findings and identified the variables influencing the correlation between F-choline PET/ceCT and surgical findings. Read More

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Contemporary Multimodality Imaging of Primary Hyperparathyroidism.

Radiographics 2022 May-Jun;42(3):841-860. Epub 2022 Apr 15.

From the Department of Radiology (M.N., S.R.K., A.A., J.E.J., C.J.H., T.D.B.) and Department of Endocrine and Thyroid Surgery (F.P.), Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, England; Department of Radiology, Dartford and Gravesham NHS Trust, Kent, England (D.O.); and Department of Surgery and Cancer, Imperial College London, London, England (T.D.B.).

Primary hyperparathyroidism (PHPT) is a disorder characterized by hypercalcemia and an elevated or inappropriately normal parathyroid hormone level. Classic features include bone pain, fractures, renal impairment, nephrolithiasis, and mental disturbance. However, most cases of PHPT are now asymptomatic at diagnosis or associated with nonspecific neurocognitive changes. Read More

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Long-term Cure of Primary Hyperparathyroidism After Scan-Directed Parathyroidectomy: Outcomes From A UK Endocrine Surgery Unit.

World J Surg 2022 Apr 12. Epub 2022 Apr 12.

Department of Endocrine Surgery, Churchill Cancer Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK.

Background: Two-decades ago, the advent of sestamibi scintigraphy led to an enthusiastic acceptance of minimally invasive parathyroidectomy (MIP) in most surgical centres. More recently, concerns have been raised about the efficacy of limited neck exploration and some surgeons proposed bilateral neck exploration to be (once again) the gold standard operation for primary hyperparathyroidism in 2020s.

Methods: A departmental database was used to identify patients who had MIP after concordant dual localisation with sestamibi scintigraphy and ultrasound scans. Read More

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Minimally Invasive Parathyroidectomy: Can Intraoperative Parathyroid Hormone Monitoring be Omitted?

World J Surg 2022 Aug 11;46(8):1908-1914. Epub 2022 Apr 11.

Hadassah Hebrew-University School of Medicine, Jerusalem, Israel.

Background: Intraoperative PTH (ioPTH) monitoring has become widely accepted in the era of minimally invasive parathyroidectomy (MIP). The purpose of this study was to evaluate the need for ioPTH during parathyroidectomy in patients with positive preoperative imaging.

Methods: The charts of patients who underwent parathyroidectomy at three tertiary centers between the years 2012 and 2021 were retrospectively reviewed. Read More

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Selective laryngoscopy before thyroidectomy: a risk assessment.

ANZ J Surg 2022 06 11;92(6):1423-1427. Epub 2022 Apr 11.

Breast and Endocrine Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Background: Patients presenting for thyroidectomy may have an unrecognized pre-existing vocal cord palsy (VCP). This raises the danger of bilateral VCP if a patient sustains an injury to the RLN on the sole functioning side. Part of the rationale for routine preoperative laryngoscopy is to eliminate such a risk. Read More

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Thyroid Function Before and After Laparoscopic Sleeve Gastrectomy in Patients with Obesity.

Obes Surg 2022 06 1;32(6):1954-1961. Epub 2022 Apr 1.

Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

Background: Effect of laparoscopic sleeve gastrectomy (LSG) on thyroid function of patients with obesity remains unclear. The aim of this study was to evaluate the changes in thyroid function before and after LSG in patients with obesity.

Methods: Data was retrieved from a retrospectively collected database of patients with morbid obesity and normal thyroid function who received LSG. Read More

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The Diagnostic Value of Contrast Enhanced Ultrasound for Localization of Parathyroid Lesions in Primary Hyperparathyroidism: Comparison With Color Doppler Ultrasound: Comparison With Color Doppler Ultrasound.

J Ultrasound Med 2022 Mar 31. Epub 2022 Mar 31.

Department of Otolaryngology Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Objectives: Preoperative localization of pathological parathyroid glands with imaging is essential for focused unilateral neck exploration and minimally invasive techniques. Recently published studies suggested that contrast enhanced ultrasonography (CEUS) had high accuracy in the localization of hyperfunctioning parathyroid glands, with a general increase in the sensitivity as compared to conventional sonography. The purpose of this study was to determine the usefulness of CEUS in the localization of parathyroid lesions relating to surgical and histopathological data, in comparison to color Doppler ultrasound (CDUS), in the same series of patients. Read More

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Ultrasound-guided thermal ablation for hyperparathyroidism: current status and prospects.

Int J Hyperthermia 2022 ;39(1):466-474

Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: Hyperparathyroidism (HPT) is classified into primary HPT (PHPT), secondary HPT (SHPT), tertiary HPT (THPT), and pseudohyperparathyroidism. Parathyroid surgery is generally reserved for patients with symptomatic PHPT and asymptomatic patients who meet the surgical guideline criteria. However, the risk of complications and mortality after parathyroid gland surgery increases with increasing patient age. Read More

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Autofluorescence of parathyroid glands during endocrine surgery with minimally invasive technique.

J Endocrinol Invest 2022 Jul 9;45(7):1393-1403. Epub 2022 Mar 9.

Division of General Surgery, Department of Medical, Surgical, and Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy.

Purpose: Accidental injury to the parathyroid glands (PTGs) is common during thyroid and parathyroid surgery. To overcome the limitation of naked eye in identifying the PTGs, intraoperative autofluorescence imaging has been embraced by an increasing number of surgeons. The aim of our study was to describe the technique and assess its utility in clinical practice. Read More

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Pediatric intraoperative nerve monitoring during thyroid surgery: A review from the American Head and Neck Society Endocrine Surgery Section and the International Neural Monitoring Study Group.

Head Neck 2022 06 8;44(6):1468-1480. Epub 2022 Mar 8.

Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle, Martin-Luther University of Halle-Wittenberg, Halle (Saale), Germany.

Children are more likely to experience recurrent laryngeal nerve (RLN) injury during thyroid surgery. Intraoperative nerve monitoring (IONM) may assist in nerve identification and surgical decision making. A literature review of pediatric IONM was performed and used to inform a monitoring technique guide and expert opinion statements. Read More

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An essential practice summary of the new EANM guidelines for parathyroid imaging.

Q J Nucl Med Mol Imaging 2022 Jun 15;66(2):93-103. Epub 2022 Feb 15.

EANM Dosimetry Committee.

Parathyroid imaging is essential for the detection and localization of hyperfunctioning parathyroid tissue in patients with primary hyperparathyroidism (pHPT). Surgical treatment of pHPT mainly consists of minimally invasive parathyroidectomy (MIP), as a single adenoma represents the most common cause of this endocrine disorder. Successful surgery requires an experienced surgeon and relies on the correct preoperative detection and localization of hyperfunctioning parathyroid glands. Read More

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A Retrospective Cohort Study of the Utility of Ultrasound, 99mTc-Sestamibi Scintigraphy, and Four-Dimensional Computed Tomography for Pre-Operative Localization of Parathyroid Disease To Facilitate Minimally Invasive Parathyroidectomy.

Cureus 2022 Jan 12;14(1):e21177. Epub 2022 Jan 12.

Surgery, Chelmsford Breast Unit, Broomfield Hospital, Mid and South Essex NHS Foundation, Broomfield, GBR.

Background This study investigated the utility of ultrasound (US), 99mTc-Sestamibi scintigraphy (Sestamibi), and four-dimensional computed tomography (4DCT) for pre-operative localization of a single abnormal parathyroid gland prior to minimally invasive parathyroidectomy (MIP) to determine the optimum pre-operative scans to facilitate a MIP. Methods Patients with primary hyperparathyroidism who underwent curative parathyroidectomy at Broomfield Hospital, Mid and South Essex NHS Foundation Trust between 2009 and 2018 were included. Diagnostic performance parameters and the agreement between US, Sestamibi, and 4DCT were evaluated. Read More

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January 2022

Preoperative imaging in primary hyperparathyroidism: Are C-Choline PET/CT and Tc-MIBI/ Iodide subtraction SPECT/CT interchangeable or do they supplement each other?

Clin Endocrinol (Oxf) 2022 Feb 12. Epub 2022 Feb 12.

Department of Nuclear Medicine, Herlev and Gentofte Hospital, Herlev, Denmark.

Objective: Preoperative location of hyperfunctioning parathyroid glands (HPGs) is vital when planning minimally invasive surgery in patients with primary hyperparathyroidism (PHPT). Dual-isotope subtraction scintigraphy with Tc-MIBI/ Iodide using SPECT/CT and planar pinhole imaging (Di-SPECT) has shown high sensitivity, but is challenged by high radiation dose, time consumption and cost. C-Choline PET/CT (faster with a lower radiation dose) is non-inferior to Di-SPECT. Read More

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February 2022

Translaryngeal ultrasound in thyroid surgery: state of the art review.

ANZ J Surg 2022 03 8;92(3):385-389. Epub 2022 Feb 8.

Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

Background: Clinical voice assessment prior to thyroid and parathyroid surgery is essential, but the paradigm of indirect laryngoscopy (IDL), when indicated, has been challenged by the risk of aerosolised SARS-Cov-2 during endoscopy of the aerodigestive tract. Translaryngeal ultrasound (TLUS) to assess the vocal cords has been proposed as a safe, non-invasive and sensitive alternative. The aim of this review was to verify TLUS as a viable tool for perioperative laryngeal assessment. Read More

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Risk factors influencing cure of ultrasound-guided microwave ablation for primary hyperparathyroidism.

Int J Hyperthermia 2022 ;39(1):258-264

Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.

Objective: To evaluate the potential risk factors influencing cure rate of ultrasound-guided microwave ablation (MWA) for primary hyperparathyroidism (PHPT).

Materials And Methods: Seventy five patients (25 males and 50 females; mean age, 56.80 ± 12. Read More

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