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Article ; Online: Using the operating microscope to improve ergonomics for thyroidectomy.

Haigh, Philip I

2022 Volume 225, Issue 4, Page(s) 803–804

MeSH term(s)	Humans ; Thyroidectomy ; Ergonomics ; Microscopy ; Operating Rooms
Language	English
Publishing date	2022-12-07
Publishing country	United States
Document type	Editorial
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2022.12.004
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Article ; Online: Lessons from the American Association of Endocrine Surgeons (AAES) ergonomics panel: Operating is a pain in the neck … and other places.

Merrill, Andrea L / Haigh, Philip I / Lal, Geeta I

American journal of surgery

2024

Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Editorial
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2024.02.038
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Article ; Online: Parathyroidectomy for nephrolithiasis in primary hyperparathyroidism: Beneficial but not a panacea.

Huang, Siu-Yuan / Burchette, Raoul / Chung, Joanie / Haigh, Philip I

Surgery

2021 Volume 171, Issue 1, Page(s) 29–34

Abstract: Background: Nephrolithiasis is a classic indication for parathyroidectomy in primary hyperparathyroidism patients; however, the effects of parathyroidectomy on nephrolithiasis recurrence are not well studied. The aim was to determine effect of ... ...

Abstract	Background: Nephrolithiasis is a classic indication for parathyroidectomy in primary hyperparathyroidism patients; however, the effects of parathyroidectomy on nephrolithiasis recurrence are not well studied. The aim was to determine effect of parathyroidectomy on time to first nephrolithiasis recurrence and recurrence rate per patient-years. Methods: A retrospective cohort study of patients diagnosed with primary hyperparathyroidism and at least one episode of nephrolithiasis was performed. The patients were divided into observation, presurgery, and postsurgery groups. Endpoints were time to first recurrence of nephrolithiasis and average recurrence rate per patient-years. Results: The cohort was comprised of 1,252 patients. In addition, 334 (27%) patients underwent parathyroidectomy and 918 (73%) were observed. The surgical and nonsurgical groups differed significantly in age, sex, Charlson, calcium, and primary hyperparathyroidism level. Overall recurrence rate was 31.3%. The 5-, 10-, and 15-year recurrence-free survival rates were 74.4%, 56.3%, 49.5%, respectively (presurgery), 82.4%, 70.9%, 62.8%, respectively (postsurgery; P < .0001), and 86.3%, 77.7%, and 70.6%, respectively (observation). The presurgery group had an increased risk of first recurrence compared with the observation group (hazard ratio 1.89; 95% confidence interval, 1.44-2.47). The average recurrence rates among all surgical patients who recurred were 1 event per 4.3 patient-years presurgery versus 1 event per 6.7 patient-years postsurgery (P = .0001). Conclusion: Recurrent nephrolithiasis is a significant problem in patients with primary hyperparathyroidism. Parathyroidectomy prolongs the time to first recurrence and decreases the number of re-recurrences over time but does not eliminate recurrences. Observation may also be a reasonable approach in selected patients.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Calcium/blood ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Hyperparathyroidism, Primary/blood ; Hyperparathyroidism, Primary/complications ; Hyperparathyroidism, Primary/mortality ; Hyperparathyroidism, Primary/surgery ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Nephrolithiasis/blood ; Nephrolithiasis/etiology ; Nephrolithiasis/mortality ; Nephrolithiasis/surgery ; Parathyroid Hormone/blood ; Parathyroidectomy/statistics & numerical data ; Recurrence ; Retrospective Studies ; Secondary Prevention/methods ; Secondary Prevention/statistics & numerical data ; Time Factors ; Young Adult
Chemical Substances	Parathyroid Hormone ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2021-08-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2021.03.077
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Article ; Online: Long-term effects of primary hyperparathyroidism and parathyroidectomy on kidney function.

Zhu, Catherine Y / Zhou, Hui X / Tseng, Chi-Hong / Fackelmayer, Oliver J / Haigh, Philip I / Adams, Annette L / Yeh, Michael W

European journal of endocrinology

2023 Volume 189, Issue 1, Page(s) 115–122

Abstract: Importance: Limited evidence supports kidney dysfunction as an indication for parathyroidectomy in asymptomatic primary hyperparathyroidism (PHPT).: Objective: To investigate the natural history of kidney function in PHPT and whether ... ...

Abstract	Importance: Limited evidence supports kidney dysfunction as an indication for parathyroidectomy in asymptomatic primary hyperparathyroidism (PHPT). Objective: To investigate the natural history of kidney function in PHPT and whether parathyroidectomy alters renal outcomes. Design: Matched control study. Setting: A vertically integrated health care system serving 4.6 million patients in Southern California. Participants: 6058 subjects with PHPT and 16 388 matched controls, studied from 2000 to 2016. Exposures: Biochemically confirmed PHPT with varying serum calcium levels. Main outcomes: Estimated glomerular filtration rate (eGFR) trajectories were compared over 10 years, with cases subdivided by severity of hypercalcemia: serum calcium 2.62-2.74 mmol/L (10.5-11 mg/dL), 2.75-2.87 (11.1-11.5), 2.88-2.99 (11.6-12), and >2.99 (>12). Interrupted time series analysis was conducted among propensity-score-matched PHPT patients with and without parathyroidectomy to compare eGFR trajectories postoperatively. Results: Modest rates of eGFR decline were observed in PHPT patients with serum calcium 2.62-2.74 mmol/L (−1.0 mL/min/1.73 m2/year) and 2.75-2.87 mmol/L (−1.1 mL/min/1.73 m2/year), comprising 56% and 28% of cases, respectively. Compared with the control rate of −1.0 mL/min/1.73 m2/year, accelerated rates of eGFR decline were observed in patients with serum calcium 2.88-2.99 mmol/L (−1.5 mL/min/1.73 m2/year, P < .001) and >2.99 mmol/L (−2.1 mL/min/1.73 m2/year, P < .001), comprising 9% and 7% of cases, respectively. In the propensity score–matched population, patients with serum calcium >2.87 mmol/L exhibited mitigation of eGFR decline after parathyroidectomy (−2.0 [95% CI: −2.6 to −1.5] to −0.9 [95% CI: −1.5 to 0.4] mL/min/1.73 m2/year). Conclusions and relevance: Compared with matched controls, accelerated eGFR decline was observed in the minority of PHPT patients with serum calcium >2.87 mmol/L (11.5 mg/dL). Parathyroidectomy was associated with mitigation of eGFR decline in patients with serum calcium >2.87 mmol/L.
MeSH term(s)	Humans ; Hyperparathyroidism, Primary/surgery ; Calcium ; Parathyroidectomy ; Kidney ; Hypercalcemia/complications ; Parathyroid Hormone
Chemical Substances	Calcium (SY7Q814VUP) ; Parathyroid Hormone
Language	English
Publishing date	2023-07-14
Publishing country	England
Document type	Journal Article
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1093/ejendo/lvad081
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Article ; Online: Hypocalcemia after Total Thyroidectomy in Graves Disease.

Al Qubaisi, Malak / Haigh, Philip I

The Permanente journal

2019 Volume 23

Abstract: Context: Total thyroidectomy has been shown to provide a cost-effective and efficient method of permanently treating Graves disease; however, hypocalcemia can be a common complication.: Objective: To evaluate the risk of hypocalcemia after total ... ...

Abstract	Context: Total thyroidectomy has been shown to provide a cost-effective and efficient method of permanently treating Graves disease; however, hypocalcemia can be a common complication. Objective: To evaluate the risk of hypocalcemia after total thyroidectomy in patients with vs without Graves disease. Design: The 2016 American College of Surgeons National Surgical Quality Improvement Program participant use data files for procedure-targeted thyroidectomy and from 5871 patients were merged. This study included any patient who underwent total thyroidectomy. Main outcome measures: Whether symptomatic hypocalcemia developed anytime within 30 days after the thyroidectomy. A clinically severe hypocalcemic event was also evaluated as a secondary outcome measure. Results: Of the 2143 patients who underwent total thyroidectomy, 222 patients experienced hypocalcemia after surgery, 124 of whom had symptomatic hypocalcemia postoperatively. Among patients with hypocalcemia, 16.3% had Graves disease, whereas only 9.4% of patients without Graves disease experienced significant hypocalcemia. Multivariable logistic regression analysis revealed that women (odds ratio = 1.79; 95% confidence interval = 1.16-2.76; p = 0.009) and patients who underwent parathyroid autotransplantation (odds ratio = 1.91; 95% confidence interval = 1.30-2.81; p = 0.001) were at greater risk of development of hypocalcemia. Older patients were less likely to experience hypocalcemia postoperatively (odds ratio = 0.586; 95% confidence interval = 0.44-0.79; p = 0.0001). Conclusion: Patients with Graves disease are about twice as likely to experience hypocalcemia or clinically severe hypocalcemia postoperatively than are patients without the disease.
MeSH term(s)	Adult ; Aged ; Female ; Graves Disease/surgery ; Humans ; Hypocalcemia/epidemiology ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Risk ; Thyroidectomy
Language	English
Publishing date	2019-05-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2062823-7
ISSN	1552-5775 ; 1552-5767
ISSN (online)	1552-5775
ISSN	1552-5767
DOI	10.7812/TPP/18-188
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Article ; Online: Extent of thyroidectomy and survival in the SEER database: a case of citation amnesia.

Haigh, Philip I

Archives of otolaryngology--head & neck surgery

2011 Volume 137, Issue 8, Page(s) 837; author reply 837–8

MeSH term(s)	Carcinoma, Papillary/surgery ; Female ; Humans ; Male ; Thyroid Neoplasms/surgery ; Thyroidectomy/methods
Language	English
Publishing date	2011-08
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	632721-7
ISSN	1538-361X ; 0886-4470 ; 2168-6181
ISSN (online)	1538-361X
ISSN	0886-4470 ; 2168-6181
DOI	10.1001/archoto.2011.133
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Article ; Online: Influence of a negative sestamibi scan on the decision for parathyroid operation by the endocrinologist and surgeon.

Wu, Susana / Hwang, Stephanie S / Haigh, Philip I

Surgery

2017 Volume 161, Issue 1, Page(s) 35–43

Abstract: Background: It has been observed that negative sestamibi scans may impact practice patterns in patients with primary hyperparathyroidism. However, there are no published data on the issue. The objective was to elucidate the influence of negative ... ...

Abstract	Background: It has been observed that negative sestamibi scans may impact practice patterns in patients with primary hyperparathyroidism. However, there are no published data on the issue. The objective was to elucidate the influence of negative sestamibi scans on referrals by endocrinologists for parathyroidectomy and surgeon decision-making. Methods: All patients with primary hyperparathyroidism were identified within a region-wide health care system over a 2-year period. Data, including age, calcium, parathyroid hormone, renal function, bone density, and sestamibi scan results, were collected from the electronic medical record of all patients. The electronic referral system was used to track consultations with endocrinologists and surgeons. Multivariable logistic regression analysis was done to model factors involved in endocrinologist recommendations (referral or no referral to operation) and surgeon recommendations (parathyroidectomy or no parathyroidectomy). Results: A total of 539 patients with primary hyperparathyroidism were identified, and 452 were seen by endocrinologists. Of these, 260 patients had sestamibi scans done (120 negative and 140 positive), and 201 (77%) patients were referred to surgeons. Compared with positive sestamibi scans, negative sestamibi scans were independently associated with no referral to surgeons, after adjusting for presence of classic symptoms, age, fitness for operation, calcium, parathyroid hormone, glomerular filtration rate, and bone density (odds ratio = 0.36; 95% confidence interval 0.18-0.73). Surgeons saw an additional 54 patients referred from nonendocrinologists or primary care physicians and sestamibi scans were completed. Surgeons recommended parathyroidectomy in 236 of the 255 patients. Negative sestamibi scans were independently associated with no recommendation for operation (odds ratio = 0.32; 95% confidence interval 0.11-0.91). Surgeons initially scheduled and completed parathyroidectomies in 211/255 patients. Cure rate after operation was 98%, and this was not influenced by the sestamibi scan result. Conclusion: Negative sestamibi scans influence decision making in the management of patients with primary hyperparathyroidism. Endocrinologists commonly order sestamibi scans, and if negative, they are less likely to refer patients to surgeons. Surgeons are also influenced by sestamibi scans, and if negative, they are less likely to recommend parathyroidectomy. Cure rate in sestamibi-negative patients is excellent after operation.
MeSH term(s)	Adult ; Aged ; Clinical Decision-Making ; Cohort Studies ; Confidence Intervals ; Databases, Factual ; Endocrinologists ; Female ; Humans ; Hyperparathyroidism, Primary/diagnostic imaging ; Hyperparathyroidism, Primary/surgery ; Male ; Middle Aged ; Odds Ratio ; Parathyroidectomy/methods ; Preoperative Care/methods ; Radionuclide Imaging/methods ; Referral and Consultation ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Surgeons ; Technetium Tc 99m Sestamibi
Chemical Substances	Technetium Tc 99m Sestamibi (971Z4W1S09)
Language	English
Publishing date	2017-01
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2016.05.048
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Article: BIOCHEMICAL DYNAMICS OF UNTREATED PRIMARY HYPERPARATHYROIDISM: AN OBSERVATIONAL STUDY.

Yeh, Michael W / Zhou, Hui / Kuo, Eric J / Adams, Annette L / Li, Ning / Haigh, Philip I

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2019 Volume 25, Issue 5, Page(s) 470–476

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Calcium ; California ; Humans ; Hyperparathyroidism, Primary ; Parathyroid Hormone ; Parathyroidectomy ; Retrospective Studies
Chemical Substances	Parathyroid Hormone ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2019-01-18
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	1473503-9
ISSN	1530-891X
ISSN	1530-891X
DOI	10.4158/EP-2018-0489
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Article ; Online: End-organ effects of primary hyperparathyroidism: A population-based study.

Assadipour, Yasmine / Zhou, Hui / Kuo, Eric J / Haigh, Philip I / Adams, Annette L / Yeh, Michael W

Surgery

2018 Volume 165, Issue 1, Page(s) 99–104

Abstract: Background: Patients with primary hyperparathyroidism are at risk for skeletal and renal end-organ damage.: Methods: We studied patients with biochemically confirmed primary hyperparathyroidism from 1995-2014 and quantified the frequency of ... ...

Abstract	Background: Patients with primary hyperparathyroidism are at risk for skeletal and renal end-organ damage. Methods: We studied patients with biochemically confirmed primary hyperparathyroidism from 1995-2014 and quantified the frequency of osteoporosis, nephrolithiasis, hypercalciuria, and decrease in renal function. Results: The cohort comprised 9,485 patients. In total, 3,303 (35%) had preexisting end-organ effects (osteoporosis, 24%; nephrolithiasis, 10%; hypercalciuria, 5%). Of 6,182 remaining patients, 1,769 (29%) exhibited progression to 1 or more end-organ effects over a median 3.7 years. Among patients with classic primary hyperparathyroidism (calcium and parathyroid hormone increased), progression was unrelated to the degree of hypercalcemia (calcium >11.5 mg/dL, hazard ratio 1.03, 95% confidence interval 0.85-1.25; 11.1-11.5 mg/dL, HR 1.07, 95% confidence interval 0.93-1.23; 10.5-11.0 mg/dL = reference). Patients with nonclassic primary hyperparathyroidism (calcium increased, parathyroid hormone 40-65 pg/mL) had a lesser risk of progression (calcium >11.5 mg/dL, hazard ratio 0.68, 95% confidence interval 0.50-0.94; 11.1-11.5 mg/dL, hazard ratio 0.68, 95% confidence interval 0.56-0.82; 10.5-11.0 mg/dL, hazard ratio 0.66, 95% confidence interval 0.59-0.74). End-organ damage developed before or within 5 years of diagnosis for 62% of patients. Conclusion: End-organ manifestations of primary hyperparathyroidism develop before biochemical diagnosis or within 5 years in most patients. End-organ damage occurred more frequently in patients with classic primary hyperparathyroidism versus nonclassic primary hyperparathyroidism, regardless of severity of hypercalcemia.
MeSH term(s)	Aged ; Calcium/blood ; Cohort Studies ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Hypercalciuria/etiology ; Hyperparathyroidism, Primary/complications ; Male ; Middle Aged ; Nephrolithiasis/etiology ; Osteoporosis/etiology ; Severity of Illness Index
Chemical Substances	Calcium (SY7Q814VUP)
Language	English
Publishing date	2018-11-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2018.04.088
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Article ; Online: Population-Level Incidence and Predictors of Surgically Induced Diabetes and Exocrine Insufficiency after Partial Pancreatic Resection.

Elliott, Irmina A / Epelboym, Irene / Winner, Megan / Allendorf, John D / Haigh, Philip I

The Permanente journal

2017 Volume 21, Page(s) 16–95

Abstract: Context: Endocrine and exocrine insufficiency after partial pancreatectomy affect quality of life, cardiovascular health, and nutritional status. However, their incidence and predictors are unknown.: Objective: To identify the incidence and ... ...

Abstract	Context: Endocrine and exocrine insufficiency after partial pancreatectomy affect quality of life, cardiovascular health, and nutritional status. However, their incidence and predictors are unknown. Objective: To identify the incidence and predictors of new-onset diabetes and exocrine insufficiency after partial pancreatectomy. Design: We retrospectively reviewed 1165 cases of partial pancreatectomy, performed from 1998 to 2010, from a large population-based database. Main outcome measures: Incidence of new onset diabetes and exocrine insufficiency RESULTS: Of 1165 patients undergoing partial pancreatectomy, 41.8% had preexisting diabetes. In the remaining 678 patients, at a median 3.6 months, diabetes developed in 274 (40.4%) and pancreatic insufficiency developed in 235 (34.7%) patients. Independent predictors of new-onset diabetes were higher Charlson Comorbidity Index (CCI; hazard ratio [HR] = 1.62 for CCI of 1, p = 0.02; HR = 1.95 for CCI ≥ 2, p < 0.01) and pancreatitis (HR = 1.51, p = 0.03). There was no difference in diabetes after Whipple procedure vs distal pancreatic resections, or malignant vs benign pathologic findings. Independent predictors of exocrine insufficiency were female sex (HR = 1.32, p = 0.002) and higher CCI (HR = 1.85 for CCI of 1, p < 0.01; HR = 2.05 for CCI ≥ 2, p < 0.01). Distal resection and Asian race predicted decreased exocrine insufficiency (HR = 0.35, p < 0.01; HR = 0.54, p < 0.01, respectively). Conclusion: In a large population-based database, the rates of postpancreatectomy endocrine and exocrine insufficiency were 40% and 35%, respectively. These data are critical for informing patients' and physicians' expectations.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Comorbidity ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/etiology ; Exocrine Pancreatic Insufficiency/epidemiology ; Exocrine Pancreatic Insufficiency/etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pancreas/pathology ; Pancreas/surgery ; Pancreatectomy/adverse effects ; Pancreatitis/complications ; Pancreatitis/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Proportional Hazards Models ; Retrospective Studies ; Risk ; Sex Factors ; Young Adult
Language	English
Publishing date	2017-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2062823-7
ISSN	1552-5775 ; 1552-5767
ISSN (online)	1552-5775
ISSN	1552-5767
DOI	10.7812/TPP/16-095
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