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dc.contributor.authorMiller, Julie A
dc.contributor.authorGundara, Justin
dc.contributor.authorHarper, Simon
dc.contributor.authorHerath, Madhuni
dc.contributor.authorRamchand, Sabashini K
dc.contributor.authorFarrell, Stephen
dc.contributor.authorSerpell, Jonathan
dc.contributor.authorTaubman, Kim
dc.contributor.authorChristie, James
dc.contributor.authorGirgis, Christian M
dc.contributor.authorSchneider, Hans G
dc.contributor.authorClifton-Bligh, Roderick
dc.contributor.authorGill, Anthony J
dc.contributor.authorDe Sousa, Sunita MC
dc.contributor.authorCarroll, Richard W
dc.contributor.authoret al.
dc.date.accessioned2022-01-10T08:29:27Z
dc.date.available2022-01-10T08:29:27Z
dc.date.issued2021
dc.identifier.issn0300-0664
dc.identifier.doi10.1111/cen.14650
dc.identifier.urihttp://hdl.handle.net/10072/411356
dc.description.abstractObjective: To develop evidence-based recommendations to guide the surgical management and postoperative follow-up of adults with primary hyperparathyroidism. Methods: Representatives from relevant Australian and New Zealand Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing eight key questions. Results: Diagnostic imaging does not determine suitability for surgery but can guide the planning of surgery in suitable candidates. First-line imaging includes ultrasound and either parathyroid 4DCT or scintigraphy, depending on local availability and expertise. Minimally invasive parathyroidectomy is appropriate in most patients with concordant imaging. Bilateral neck exploration should be considered in those with discordant/negative imaging findings, multi-gland disease and genetic/familial risk factors. Parathyroid surgery, especially re-operative surgery, has better outcomes in the hands of higher volume surgeons. Neuromonitoring is generally not required for initial surgery but should be considered for re-operative surgery. Following parathyroidectomy, calcium and parathyroid hormone levels should be re-checked in the first 24 h and repeated early if there are risk factors for hypocalcaemia. Eucalcaemia at 6 months is consistent with surgical cure; parathyroid hormone levels do not need to be re-checked in the absence of other clinical indications. Longer-term surveillance of skeletal health is recommended. Conclusions: This position statement provides up-to-date guidance on evidence-based best practice surgical and postoperative management of adults with primary hyperparathyroidism.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherWiley
dc.relation.ispartofjournalClinical Endocrinology
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchEndocrinology
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode320208
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsEndocrinology & Metabolism
dc.subject.keywordsMINIMALLY-INVASIVE PARATHYROIDECTOMY
dc.subject.keywordsBILATERAL NECK EXPLORATION
dc.titlePrimary hyperparathyroidism in adults-(Part II) surgical management and postoperative follow-up: Position statement of the Endocrine Society of Australia, The Australian & New Zealand Endocrine Surgeons, and The Australian & New Zealand Bone and Mineral Society
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationMiller, JA; Gundara, J; Harper, S; Herath, M; Ramchand, SK; Farrell, S; Serpell, J; Taubman, K; Christie, J; Girgis, CM; Schneider, HG; Clifton-Bligh, R; Gill, AJ; De Sousa, SMC; Carroll, RW; et al., Primary hyperparathyroidism in adults-(Part II) surgical management and postoperative follow-up: Position statement of the Endocrine Society of Australia, The Australian & New Zealand Endocrine Surgeons, and The Australian & New Zealand Bone and Mineral Society, Clinical Endocrinology, 2021
dcterms.dateAccepted2021-11-02
dc.date.updated2022-01-10T08:27:51Z
gro.description.notepublicThis publication has been entered as an advanced online version in Griffith Research Online.
gro.hasfulltextNo Full Text
gro.griffith.authorGundara, Justin


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