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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

Grant V. Bochicchio MD,MPH, FACS
Grant V. Bochicchio MD,MPH, FACS is the Chief of Acute and Critical Care Surgery and the Edison Professor of Surgery at Washington University in St. Louis. He has published over 100 peer reviewed articles including numerous articles in the area of hyperglycemia and tight glycemic control. In addition, he has been awarded several research grants for work in this area and has served on numerous expert panels including those sponsored by the FDA and the NIH.

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