Subtotal parathyroidectomy for primary hyperparathyroidism. Long-term results in 292 patients.
Subtotal parathyroidectomy was performed in a consecutive series of 292 patients with primary hyperparathyroidism. We evaluated the long-term postoperative results during a period of 16 years. Patients ranged in age from 14 to 83 years and included 176 women and 116 men. Of these, 16% had a history of exposure to radiation in childhood or adolescence, while thyroid disease requiring some form of thyroidectomy coexisted in 91 (31%) of the patients. Histologic information on three or more parathyroid glands was obtained in 73% of the cases. We considered 285 patients (97.6%) cured after their first operation. The remaining seven patients (2.4%) had persistent hyperparathyroidism. However, five were cured after a sternum-splitting mediastinal exploration and one after a second neck exploration. The seventh remains hypercalcemic despite a subsequent mediastinal exploration. Temporary postoperative hypoparathyroidism occurred in 10% of our cases and permanent hypoparathyroidism in 1%. There have been no instances of recurrent hyperparathyroidism.
D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery; D000236:Adenoma / Q000150:complications / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000150:complications / Q000601:surgery; D013965:Thyroidectomy; D013966:Thyroiditis / Q000150:complications / Q000601:surgery