Patricia Irvin Donovan

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OBJECTIVE To compare the results of minimally invasive parathyroidectomy (MIP) and conventional parathyroid surgery. BACKGROUND Primary hyperparathyroidism is a common endocrine disorder often treated by surgical intervention. Outpatient MIP, employing image-directed focused exploration under cervical block anesthesia, has replaced traditional surgical(More)
OBJECTIVE To review the outcomes of 100 consecutive minimally invasive parathyroid explorations. SUMMARY BACKGROUND DATA Minimally invasive parathyroidectomy (MIP) has challenged the traditional approach of bilateral neck exploration for patients with primary hyperparathyroidism. Most patients with primary hyperparathyroidism have a single adenoma that(More)
OBJECTIVE To evaluate the clinical utility of frozen section in patients with follicular neoplasms of the thyroid in a randomized prospective trial. SUMMARY BACKGROUND DATA The finding of a follicular neoplasm on fine-needle aspiration prompts many surgeons to perform intraoperative frozen section during thyroid lobectomy. However, the focal distribution(More)
OBJECTIVE To review the outcomes in 130 consecutive remedial explorations for primary hyperparathyroidism. SUMMARY BACKGROUND DATA Remedial surgery for primary hyperparathyroidism is challenging and requires meticulous preoperative evaluation and imaging to expedite a focused surgical exploration that has traditionally been performed under general(More)
BACKGROUND Remedial cervical exploration for persistent or recurrent primary hyperparathyroidism can be technically difficult, but is expedited by accurate preoperative localization. We investigated the use of real-time super selective venous sampling (sSVS) in the setting of negative noninvasive imaging modalities. STUDY DESIGN We performed a(More)
OBJECTIVE To determine the usefulness of the rapid parathyroid hormone (PTH) assay during venous localization for primary hyperparathyroidism (1 degrees HPTH). SUMMARY BACKGROUND DATA Remedial exploration for persistent 1 degrees HPTH poses a significant challenge when noninvasive preoperative localization studies are negative. Based on experience with(More)
BACKGROUND Delayed technetium-99m sestamibi single photon emission computed tomography (SPECT) scans were prospectively analyzed in a large series of patients with primary hyperparathyroidism. METHODS Three hundred thirty-eight patients underwent sestamibi-SPECT and were explored. Prospective data included preoperative demographics, clinical, sestamibi,(More)
Parathyroid exploration through a standard cervical approach is adequate for the resection of most mediastinal parathyroid glands. A subset of mediastinal parathyroid glands causing hyperparathyroidism, however, cannot be removed in this manner. We reviewed our experience with the use of partial median sternotomy in the treatment of these patients. Over a(More)
HYPOTHESIS We investigated the frequency and reasons for conversion from cervical block anesthesia to general anesthesia (GA) in patients undergoing minimally invasive parathyroidectomy for primary hyperparathyroidism. DESIGN Prospective case series. SETTING Tertiary university hospital. PATIENTS A total of 441 consecutive patients with primary(More)
HYPOTHESIS The sensitivity of sestamibi scanning techniques used for preoperative localization in primary hyperparathyroidism is a function of the parameters of image acquisition and processing. DESIGN Criterion standard vs optimized technique. SETTING Tertiary referral center. PATIENTS One hundred forty-eight consecutive patients with primary(More)