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Annals of Surgery Journal Club
Interactive resource for surgery residents and surgeons to discuss and critically evaluate articles published in Annals of Surgery selected by a monthly guest expert who will review an article each month, offer questions and respond to reader's comments.
Monday, January 30, 2012
Annals of Surgery Journal Club Final Comment from Herb Chen
The surgical approach to patients with primary hyperparathyroidism continues to be controversial. While Dr. Udelsman and colleagues believe that target or minimally invasive parathyroidectomy is optimal, a poll of the participants in this journal club suggest otherwise. In fact, by a ratio of 3:1, our readers do not agree with Dr. Udelsman’s conclusions and prefer bilateral exploration. Interestingly, there are data from multiple institutions, including our own, that with longer term follow-up minimally invasive parathyroidectomy may be associated with a slightly higher recurrence rate. In any case, in the hands of experienced surgeons, both techniques have been proven to be effective and safe. I think all surgeons can agree that the most effective therapy for patients with primary hyperparathyroidism is parathyroidectomy, and collectively we should advocate for referral of all patients with this disease for surgery. -Herb Chen, MD
About the Author

Dr. John Mullen
Dr. John Mullen is Program Director of the General Surgery Residency at the Massachusetts General Hospital, Visiting Surgeon in the Division of Surgical Oncology, and Assistant Professor of Surgery at Harvard Medical School. He completed his residency training in general surgery at the MGH in 2003, just prior to the implementation of the resident duty hour restrictions. Dr. Mullen’s clinical focus is the surgical treatment of gastric cancer and soft tissue sarcoma, and his research interests are in surgical education and clinical and translational cancer research.

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