[Results of bilateral surgical technique in primary hyperparathyroidism].
OBJECTIVE
The surgical success rate and clinical outcome after surgery for primary hyperparathyroidism were evaluated in a prospective long-term follow-up study.


METHODS
407 patients, 396 with the first manifestation, 6 with recurrent and 5 with persistent disease underwent operation from August 1, 1987 to August 15, 1999. All patients were prospectively investigated in a long-term follow-up study and underwent reexaminations at regular surveillance intervals. The postoperative course is known in 93.9% of all patients.


RESULTS
The prevalence of asymptomatic primary hyperparathyroidism was 5.6% in our patients. Surgical cure was obtained in 97.7% of patients after initial neck exploration. In 58% of the patients with hypercalcaemic syndrome recovery occurred within the first month after surgery. Skeletal symptoms persisted in 24% of patients two years after the operation.


CONCLUSIONS
In primary hyperparathyroidism bilateral neck exploration yielded a high surgical success rate and provided long-term relief of symptoms. The morbidity of parathyroid surgery was influenced by a concomitant thyroid resection and a relationship was established between the number of intraoperatively identified parathyroid glands and the morbidity of the operation.
Walgenbach
S
S
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität Mainz.
Junginger
T
T
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery*; D002118:Calcium / Q000097:blood; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000601:surgery*; D007828:Laryngoscopy; D009364:Neoplasm Recurrence, Local; D017063:Outcome Assessment, Health Care; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy; D011446:Prospective Studies; D013997:Time Factors
D010281:Parathyroid Hormone; D002118:Calcium