[Surgical therapy of primary hyperparathyroidism and it's complications. Experience with 453 patients].
453 patients underwent surgery for primary hyperparathyreoidism between 1994 and 2003. In all patients, biochemical parameters were monitored and X-ray with USG of the neck was done. Struma nodosa was concommitantly present in 48 % of treated patients with primary hyperparathyroidism. In such cases, MRI offers better resolution of soft tissues. 98.6 % of treated patients had postoperative decrease of blood calcium to normal level. 5.4 % of cases were reoperations for primary hyperparathyroidism. In 12 % of cases, pathologically changed parathyroid glands in dystopic localization were found. In these dystopic localizations, pathologic parathyroid glands were found: in 3 % intrathyroid, in 7 % mediastinal and in 2 % of all 453 cases in other localization. In 4 % of patients, sternotomy was necessary. Persistent hypocalcemia was not registered in any patient. Transient hypocalcemia with necessity of infusion therapy was observed in 3.5 % of patients. Postoperative hypercalcemia persisted in 1.2 % of patients. Recurrent hypercalcemia was present in 0.2 % of cases. In three cases (0.7 %), unilateral injury of recurrent laryngeal nerve was observed.
Adámek
S
S
III. chirurgická klinika l. LF UK, Praha. sadamek@post.cz
Libánský
P
P
Nanka
O
O
Sedý
J
J
Pafko
P
P
D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006044:Goiter, Nodular / Q000175:diagnosis; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D006965:Hyperplasia; D007431:Intraoperative Complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D010280:Parathyroid Glands / Q000002:abnormalities / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012008:Recurrence; D061226:Recurrent Laryngeal Nerve Injuries; D012086:Reoperation; D012307:Risk Factors; D014463:Ultrasonography
D010281:Parathyroid Hormone