Re-operation for secondary hyperparathyroidism.
OBJECTIVE
In cases of re-operation for secondary hyperparathyroidism, to evaluate the extent to which the location of recurrent hyperplasia was predicted by (1) operative data from the first intervention, and (2) pre-operative imaging (before the re-operation).


METHODS
The files of 18 patients undergoing surgery for recurrent secondary hyperparathyroidism were reviewed. The surgical findings were compared both with the report of the initial operation and with the results of pre-operative imaging (i.e. ultrasonography, Mibi scintigraphy or computed tomography).


RESULTS
The location of the recurrent hyperplasia corresponded with the data for the primary intervention in about one-third of patients. There was a partial correlation in one-third of patients, and no correlation at all in one-third. Pre-operative imaging enabled better prediction of the location of recurrent disease.


CONCLUSIONS
Surgeons should have both sources of information at their disposal when planning a re-intervention for secondary hyperparathyroidism. However, in our series, the predictive value of imaging was superior to that of information deduced from the previous surgical record.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium. frans.debruyne@uz.kuleuven.be
F
F
Debruyne
G
G
Geuens
V
V
Vander Poorten
P
P
Delaere
D000293:Adolescent; D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis* / Q000601:surgery; D006965:Hyperplasia / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D012008:Recurrence; D012086:Reoperation; D012680:Sensitivity and Specificity