The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism.

@article{Wilhelm2016TheAA,
  title={The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism.},
  author={Scott M. Wilhelm and Tracy S. Wang and Daniel T. Ruan and James A. Lee and Sylvia L. Asa and Quan-yang Duh and Gerard M. Doherty and Miguel F. Herrera and Janice L. Pasieka and Nancy D. Perrier and Shonni J. Silverberg and Carmen C. Sol{\'o}rzano and Cord Sturgeon and Mitchell E. Tublin and Robert Udelsman and Sally E. Carty},
  journal={JAMA surgery},
  year={2016},
  volume={151 10},
  pages={
          959-968
        }
}
Importance Primary hyperparathyroidism (pHPT) is a common clinical problem for which the only definitive management is surgery. [] Key MethodEvidence Review A multidisciplinary panel used PubMed to review the medical literature from January 1, 1985, to July 1, 2015. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus.
View on PubMed
jamanetwork.com
683 Citations
Highly Influential Citations
54
Background Citations
192
Methods Citations
47
Results Citations
10

Figures from this paper

683 Citations

Management of primary and renal hyperparathyroidism: guidelines from the German Association of Endocrine Surgeons (CAEK)

Surgery is the only curative treatment for pHPT and should be considered for all patients with pHPT, and parathyroidectomy is indicated only when conservative treatment options fail, andParathyroid carcinoma is addressed and require special surgical expertise.

Indications for Surgical Management of Hyperparathyroidism: A Review

The reviewed literature suggests that there were improved outcomes among patients with asymptomatic pHPT who underwent curative surgery and the most recent consensus conference guidelines suggested that most patients with pHPT should be considered for parathyroidectomy.

Recent advances in the understanding and management of primary hyperparathyroidism

This article highlights updates in parathyroid disease and advances inParathyroid surgery; it does not provide a comprehensive summary of the disease process or a review of surgical indications, which can be found in the AAES guidelines or NIH Symposium on primary hyperparathyroidism.

Management of Primary Hyperparathyroidism: Can We Do Better?

Suboptimal adherence with consensus recommendations in management of PHPT is confirmed, and a minority of clinicians demonstrated solid familiarity with management strategies, paralleling their treatment approach.

The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism

Clinical guidelines were created to assist clinicians in the optimal management of secondary and tertiary renal hyperparathyroidism and outline the preoperative, intraoperative, and postoperative management of SHPT and THPT.

Perioperative Evaluation of Primary Hyperparathyroidism

Regular monitoring of calcium, albumin, and occasional PTH measurements are required after parathyroidectomy to confirm surgical cure and detect development of hypocalcemia and hypoparathyroidism.

Single Center Experience in the Surgical Management of Primary Hyperparathyroidism

Routine use of preoperative imaging modalities reduced the risk of complications in the authors' clinic and revealed three patients have parathyroid carcinoma.

How Best to Approach Surgery for Primary Hyperparathyroidism-Can We All Agree?

The new guidelines for the definitive management of primary hyperparathyroidism from the American Association of Endocrine Surgeons (AAES) published in JAMA Surgery are a welcome addition to the literature, especially because they are written for the practicing surgeon.

Primary Hyperparathyroidism: Defining the Appropriate Preoperative Imaging Algorithm.

In this article, imaging strategies before first surgery as well as in the case of repeat surgery for persistent or recurrent primary hyperparathyroidism are discussed, and a preferred algorithm and alternative options are described.

The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults.

These clinical guidelines analyze the indications for thyroidectomy as well as its definitions, technique, morbidity, and outcomes and were created to assist clinicians in the optimal surgical management of thyroid disease.
...

References

SHOWING 1-10 OF 47 REFERENCES

The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop.

The frequency of hereditary forms of PHPT may be underappreciated and needs to be assessed with increased vigilance, and surgery is likely to benefit patients due to high cure rates, low complication rates, and the likelihood of reversing skeletal manifestations.

Age as a criterion for surgery in primary hyperparathyroidism.

Surgical Management of Familial Hyperparathyroidism

In the February 2007 issue of the journal, the members of the Section of Endocrine Surgery at the University of Wisconsin report their experience with radioguided parathyroidectomy in 19 patients with familial hyperparathyroidism, finding the parathyroids is of value only if one knows how many to remove, when to cryopreserve, and when and where to autograft.

Surgery or surveillance for mild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial.

In patients with mild asymptomatic primary hyperparathyroidism, successful PTx is followed by an improvement in BMD and quality of life, and most patients followed without surgery did not show evidence of progression.

Familial Parathyroid Tumors: Diagnosis and Management

The goals of parathyroidectomy in familial HPT are to achieve and maintain normocalcemia for the longest time possible, avoid both iatrogenic hypocalcemi and operative complications, and facilitate future surgery for recurrent disease.

Cost-effectiveness analysis of parathyroidectomy for asymptomatic primary hyperparathyroidism.

The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years.

Parathyroidectomy led to normalization of biochemical indices and sustained increases in BMD, which raises questions regarding how long patients with PHPT should be followed up without intervention.

The long-term benefit of parathyroidectomy in primary hyperparathyroidism: a 10-year prospective surgical outcome study.

Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop.

It is concluded that reference ranges should be established for serum PTH in vitamin D-replete healthy individuals and genetic testing has the potential to be useful in the differential diagnosis of familial hyperparathyroidism or hypercalcemia.

Progress in the Operative Management of Sporadic Primary Hyperparathyroidism Over 34 Years

LPX, with its reported advantages of minimal dissection, shorter operative time, and use in ambulatory settings, compares favorably with the traditional BNE and should be considered as a standard operative approach in SPHPT.