Our Summary

The research paper explores the changes in the approach to parathyroidectomy, a surgery to remove the parathyroid glands. This technique has shifted from a bilateral (both sides) approach to a more targeted, focused approach. The study also examines how much experience surgical trainees are getting with this procedure.

The data, which was gathered from 2014 to 2019 from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP), shows that the use of focused versus bilateral approach has remained pretty much the same over the years. In 2014, the split was 54% focused and 46% bilateral, and in 2019, it was 55% focused and 45% bilateral.

The study also found that the involvement of trainees in these procedures has declined. In 2014, 93% of these surgeries included a trainee, but by 2019, this had dropped to 74%. The participation of fellows (more advanced trainees) also decreased from 31% to 17%.

In conclusion, these results suggest that while the surgical approach to parathyroidectomy has remained stable, the opportunities for trainees to gain hands-on experience in this procedure have decreased. The authors suggest that there is a need to gather more information on the surgical training experience in this field.

FAQs

  1. What has been the shift in the approach to parathyroidectomy over the last few decades?
  2. What is the purpose of the study on parathyroidectomy trends and surgical trainees?
  3. What was the change in fellow involvement in parathyroidectomy procedures from 2014 to 2019?

Doctor’s Tip

A helpful tip a doctor might tell a patient about parathyroidectomy is to ensure they understand the importance of following post-operative care instructions, such as taking prescribed medications, attending follow-up appointments, and monitoring calcium levels. It is also important for patients to communicate any concerning symptoms or changes in their condition to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for parathyroidectomy include those with primary hyperparathyroidism, secondary hyperparathyroidism, tertiary hyperparathyroidism, parathyroid cancer, and those with severe symptoms such as kidney stones, bone loss, or high calcium levels. The decision to undergo parathyroidectomy is often based on the severity of symptoms, calcium levels, kidney function, bone density, and overall health of the patient.

Timeline

Before parathyroidectomy:

  • Patient presents with symptoms of hyperparathyroidism, such as fatigue, weakness, bone pain, and kidney stones
  • Diagnosis of hyperparathyroidism is confirmed through blood tests showing elevated levels of calcium and parathyroid hormone
  • Patient undergoes pre-operative evaluations, including imaging studies to locate the abnormal parathyroid gland
  • Surgical team discusses the procedure with the patient, explaining the risks and benefits of parathyroidectomy

After parathyroidectomy:

  • Patient undergoes surgery to remove the abnormal parathyroid gland
  • Post-operative recovery period, which may involve pain management and monitoring of calcium levels
  • Patient may experience improvement in symptoms of hyperparathyroidism, such as increased energy and reduction in bone pain
  • Follow-up appointments with the surgical team to monitor calcium levels and overall health

Overall, the timeline for a patient before and after parathyroidectomy involves diagnosis, pre-operative preparation, surgery, and post-operative recovery and follow-up care.

What to Ask Your Doctor

  1. What is the reason for recommending a parathyroidectomy?

  2. What are the potential risks and complications associated with the surgery?

  3. Will the surgery be a focused exploration or a bilateral approach?

  4. How experienced is the surgical team in performing parathyroidectomies?

  5. Will a trainee be involved in the surgery, and if so, what level of experience do they have?

  6. What is the expected recovery time and post-operative care plan?

  7. Are there any alternative treatments or options for managing hyperparathyroidism?

  8. What is the success rate of the surgery in terms of resolving symptoms and improving health outcomes?

  9. How often will follow-up appointments be needed after the surgery?

  10. Are there any specific lifestyle changes or precautions that need to be taken after the surgery?

Reference

Authors: Beck T, Burneikis T, Jin J. Journal: Am J Otolaryngol. 2023 Jul-Aug;44(4):103884. doi: 10.1016/j.amjoto.2023.103884. Epub 2023 Apr 5. PMID: 37058910