[Reoperations in primary hyperparathyroidism].
We report on 14 patients suffering from persistent (n = 13) and truly recurrent (n = 1) primary hyperparathyroidism. Reoperations were successful in 13 cases. Cervical reexploration was only required for 5 patients who had previous operations by unexperienced surgeons in other clinics. In 5 out of 7 patients operated by us, the causes of the persistent primary hyperparathyroidism were 4 adenomas and one hyperplastic gland in the mediastinum found by median sternotomy. The remaining cases were a rare ectopic location of the inferior glands and an inadequate resection in four-gland-hyperplasia. Preoperative localization procedures were carried out for most patients. 201-Tl/99m-Tc-subtraction scintigraphy has proved for localization in both the cervical region and the mediastinum to be a highly sensitive method. Reoperative parathyroid surgery can be reduced with thorough initial cervical exploration by experienced surgeons in specialized clinics.
Geipel
D
D
Chirurgische Klinik, Klinikum Berlin-Buch, Bundesrepublik Deutschland.
Wendt
F
F
Weiss
M L
ML
Mischke
W
W
Lössner
C
C
D000236:Adenoma / Q000097:blood / Q000601:surgery; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000601:surgery*; D006965:Hyperplasia; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000601:surgery; D010280:Parathyroid Glands / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000097:blood / Q000601:surgery; D016105:Parathyroidectomy; D011183:Postoperative Complications / Q000097:blood / Q000601:surgery*; D012086:Reoperation
D002118:Calcium
Reoperationen beim primären Hyperparathyreoidismus.