Surgical treatment for hyperparathyroidism

We evaluated the results of 124 patients, who have been operated on for hyperparathyroidism. Ninety-nine patients had primary hyperparathyroidism and 25 patitents had secondary hyperparathyroidism, Preoperative localization by ultrasonography was attempted in all cases, while only a few patients were preopratively evaluated by arteriography and selected vernous sampling for parathyroid hormone concentration. After surgical resection for primary hyperparathyroidism, transient postoperative hypoparathyroidism occurred in 27 patients (27.3%), recurrent disease occurred in 3 patients (3%), while 1 patient experienced persistent hyperparathyroidism (1%). In 3 patients (3%), resection of solitary adenoma and biopsy of all parathyroid glands resulted in permanent hypoparathyroidism that required long-term administration of vitamin D and oral calcium, Neither recurrent nor persistent hyperparathyroidism occurred in patients surgically treated for secondary hyperparathyroidism, and no patient experienced postoperative hypoparathyroidism, Because no study has yet demonstrated that preoperative localization improve parathyroid localization or cure rate of initial cervical exploration, me emphasize the importance of an adequate surgical strategy and a diligent search for parathyroid glands in the neck region for treatment of this challenging disease.