Long-term results of unilateral neck exploration for preoperatively localized nonfamilial parathyroid adenomas.
BACKGROUND
Unilateral neck exploration for sporadic parathyroid adenomas remains a contentious policy. The morbidity is lower than for bilateral surgery, but the long-term outcome may be inferior.


METHODS
The results of a policy of unilateral neck exploration for primary hyperparathyroidism based on preoperative localization are reviewed.


RESULTS
Over a 10-year period, 89 patients were operated on, 57 undergoing unilateral neck exploration. Unilateral neck exploration significantly reduced operative time (P < 0.0001) and postoperative hypocalcaemia (P = 0.021). Over a mean biochemical follow-up of 38 months, recurrent hypercalcaemia occurred in 6% of patients, including 3.5% of those undergoing unilateral neck exploration, an additional 10% of patients were normocalcaemic with an inappropriately elevated parathormone level.


CONCLUSIONS
A policy of unilateral neck exploration can achieve comparable long-term results to more extensive bilateral surgery.
Robertson
G S
GS
Department of Surgery, Leicester Royal Infirmary, United Kingdom.
Johnson
P R
PR
Bolia
A
A
Iqbal
S J
SJ
Bell
P R
PR
D000236:Adenoma / Q000601:surgery*; D000758:Anesthesia; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D009929:Organ Size; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome