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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

Gregory D. Kennedy, MD, PhD
Gregory D. Kennedy, MD, PhD is an Associate Professor of Surgery and Vice Chair of Quality in the Department of Surgery at the University of Wisconsin School of Medicine and Public Health in Madison, WI. As a busy colon and rectal surgeon he is passionate about quality improvement and tirelessly works to ensure care of the highest quality is delivered to the patients served by the UW. He serves on many committees charged with reducing health care associated infections and is the surgeon champion of the American College of Surgeons National Surgical Quality Improvement Project for UW Health.

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