Our Summary

This research paper discusses a study on the safety and effectiveness of same-day surgery for children and teenagers who suffer from primary hyperparathyroidism (pHPT), a condition where the parathyroid glands produce too much parathyroid hormone. This condition can lead to symptoms like fatigue, joint pain, and kidney stones.

From 2002 to 2020, 19 patients aged between 8 and 18 years old had their parathyroid glands removed in an outpatient setting by a highly experienced endocrine surgeon. The results were encouraging: only two patients had complications related to calcium levels in their blood, one of which was temporary. There were no cases of voice changes, unplanned hospital admissions, wound complications, or emergency room visits.

The conclusion of the study is that this type of surgery can be safely and effectively performed on pediatric patients with pHPT, in an outpatient setting. This means that the patients can go home on the same day of the surgery. The study is classified as a Level III Treatment Study.

FAQs

  1. What is primary hyperparathyroidism (pHPT) and what symptoms can it cause?
  2. How safe and effective is same-day parathyroidectomy for children and teenagers suffering from pHPT?
  3. What were the complications, if any, observed in the study on same-day parathyroid removal?

Doctor’s Tip

A helpful tip a doctor might give a patient about parathyroidectomy is to follow post-operative instructions carefully, including taking prescribed medications, monitoring calcium levels, and attending follow-up appointments. It is important to report any symptoms or concerns to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for parathyroidectomy include those with primary hyperparathyroidism (pHPT) who have symptoms such as fatigue, joint pain, kidney stones, and high levels of calcium in the blood. Additionally, patients who do not respond well to conservative treatments, have complications from the condition, or have a family history of pHPT may also be recommended for parathyroidectomy. In the case of the study mentioned above, pediatric patients between the ages of 8 and 18 with pHPT were recommended for parathyroidectomy if they met certain criteria.

Timeline

Before the parathyroidectomy:

  • Patients experience symptoms of primary hyperparathyroidism, such as fatigue, joint pain, and kidney stones.
  • Patients undergo diagnostic tests to confirm the diagnosis of pHPT.
  • Patients consult with an endocrine surgeon to discuss the option of parathyroidectomy.
  • Pre-operative preparations are made, including fasting and medical evaluations.

After the parathyroidectomy:

  • The surgery is performed in an outpatient setting by a highly experienced endocrine surgeon.
  • Patients are monitored post-operatively for any complications, such as changes in blood calcium levels.
  • Patients are discharged home on the same day of the surgery.
  • Follow-up appointments are scheduled to monitor the patient’s recovery and ensure the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about parathyroidectomy include:

  1. What are the risks and potential complications associated with parathyroidectomy?
  2. How experienced are you in performing parathyroid surgeries, particularly in pediatric patients?
  3. What is the success rate of parathyroidectomy in treating primary hyperparathyroidism?
  4. Will I need any special preparation or testing before the surgery?
  5. What type of anesthesia will be used during the surgery?
  6. How long will the surgery take, and how long will I need to stay in the hospital?
  7. What is the expected recovery time and what follow-up care will be needed?
  8. Will I need to take any medications or make lifestyle changes after the surgery?
  9. Are there any specific dietary restrictions I should follow post-surgery?
  10. How often will I need follow-up appointments to monitor my condition after the surgery?

These questions can help the patient better understand the procedure, potential outcomes, and post-operative care involved in a parathyroidectomy.

Reference

Authors: Ramonell KM, Fazendin J, Lovell K, Iyer P, Chen H, Lindeman B, Dream S. Journal: J Pediatr Surg. 2022 Mar;57(3):410-413. doi: 10.1016/j.jpedsurg.2021.02.057. Epub 2021 Feb 25. PMID: 33745744