Reoperative Parathyroidectomy

From the 294 consecutive patients with more than 6 months of follow-up, including all known operative failures, 32 were reoperative cases from which 27 (84%) were successfully treated with a limited parathyroidectomy and unilateral neck exploration. QPTH correctly predicted the postoperative outcome in 31 of 32 patients (27 true positive and 4 true negative). There was one false-positive result due to a technician's error. The falsely elevated pre-excision PTH level in this patient was later found to be wrong by measurement of control serum. There were no false-negative results in this group. In two patients with MGD, QPTH predicted failure intraoperatively despite the resection of one or more parathyroid glands. In addition, QPTH identified the resection of nonparathyroid tissue misinterpreted as parathyroid glands in 8 patients, with a total of 13 true-negative results. The reoperative patients had an average operative time of 108 minutes (range, 35 to 325 minutes), with 6 of these patients eligible for same-day discharge.

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