These results in difficult @entity1 with previously missed @entity3243 demonstrate that a prospective strategy to treat these @entity1 surgically can be used with a high degree of success. This strategy required collaboration among endocrinologists, radiologists, and surgeons. Prospectively, only @entity1 with symptomatic persistent or recurrent @entity459 were included. Operative reports and pathology results from the initial operation and all previous operations were reviewed in detail. @entity1 with @entity1631 or @entity2741 from other causes were excluded. State-of-the-art radiologic localization procedures were used to localize the abnormal parathyroid gland. Most @entity1 had only noninvasive procedures, such as the sestamibi scan, but some whose results were equivocal underwent invasive localization, including selective angiography and venous sampling. All @entity1 underwent surgery even if the localization procedures were negative. The operative approach and strategy were dependent on the previous operative result and results of the imaging studies. Operative techniques like IOUS and urinary @entity268 determination helped facilitate a more rapid successful outcome. However, in some @entity1 , operative success was only achieved by complete dissection and removal of all tissue that might harbor the @entity652 such as a lobe of the thyroid or the thymus. Abnormal parathyroid tissue was cryopreserved for possible subsequent autotransplantation in the event of @entity261 . The reoperative success rate for missed @entity652 was 97%, the highest ever reported with a very acceptable complication rate and no deaths. @entity86 , which was really a complication of the initial previous operations during which normal parathyroid tissue was removed, was treated by autotransplantation of cryopreserved tissue in 12 @entity1 , and 8 functioned perfectly. With attention to details and possible pitfalls, reoperations for missed @entity3243 can be performed safely and effectively.

Reoperation for missed XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1631 :: ('846', 'Gene') :: ['FHH'] @entity459 :: ('MESH:D049950', 'Disease') :: ['primary hyperparathyroidism'] @entity268 :: ('CHEBI:17489', 'Chemical') :: ['cAMP'] @entity2741 :: ('MESH:D006934', 'Disease') :: ['hypercalcemia'] @entity261 :: ('MESH:D007011', 'Disease') :: ['hypoparathyroidism'] @entity86 :: ('MESH:D019106', 'Disease') :: ['Postoperative hypoparathyroidism'] @entity3243 :: ('MESH:D010282', 'Disease') :: ['parathyroid adenomas'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenoma']
@entity3243 :: (MESH:D010282,Disease) :: ['parathyroid adenoma']
