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What steps should be considered in the patient who has had a negative cervical exploration for primary hyperparathyroidism
Clinical Endocrinology, 10/15/09
Harrison B – The surgeon must have a detailed knowledge of the nuances of parathyroid embryology and a meticulous surgical technique, not only to identify and safely remove the retained gland/s but also do so without causing unnecessary morbidity. Results of re–operation (84–98% cure) from centres of excellence are highly commendable, yet the use of `new' technology (that includes intra–operative PTH) has not translated into improved outcomes in all cases. Some parathyroid glands are extremely difficult to find! Re–operative parathyroid surgery is a challenge, sometimes easy, and on other occasions extremely difficult.
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