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Adv Surg. 2007;41:1-15.

Remedial surgery for primary hyperparathyroidism.

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Yale-New Haven Hospital, 20 York Street, New Haven, CT 06510, USA.


Remedial parathyroid surgery is a complex undertaking for even the most experienced parathyroid surgeon. It involves a careful preoperative evaluation, including the confirmation of the initial diagnosis of primary HPTH, use of the appropriate localization studies, knowledge of the details of the previous exploration, and surgical re-exploration, including the use of intraoperative localization adjuncts, such as the rapid intraoperative PTH assay (Fig. 6). Althoughthe success rate of remedial explorations can be as high as 98%, complication rates are higher than in initial cervical explorations for parathyroid disease.

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