A number of surgeons consider bilateral neck exploration (BNE) to be the treatment of choice in patients with primary hyperparathyroidism (HPT), mainly because it has a success rate in the order of 95% [1]. In clinical centres that use BNE, preoperative localising imaging is usually felt to be of low clinical value, and tends to be reserved for patients with persistent or recurrent HPT [2]. However, primary HPT is caused by a solitary parathyroid adenoma in more than 85% of patients [3], and it seems reasonable to consider BNE an unnecessary procedure in the majority of these cases. Hence alternative surgical approaches involving limited neck exploration have been proposed, such as unilateral neck exploration (UNE) and, recently, minimally invasive parathyroidec-tomy.
展开▼
