Subtotal parathyroidectomy for primary hyperparathyroidism. Long-term results in 292 patients
E. Paloyan, A. M. Lawrence, R. Oslapas, K. H. Shah, K. Ernst and C. Hofmann
Subtotal parathyroidectomy was performed in a consecutive series of 292
patients with primary hyperparathyroidism. We evaluated the long-term
postoperative results during a period of 16 years. Patients ranged in age
from 14 to 83 years and included 176 women and 116 men. Of these, 16% had a
history of exposure to radiation in childhood or adolescence, while thyroid
disease requiring some form of thyroidectomy coexisted in 91 (31%) of the
patients. Histologic information on three or more parathyroid glands was
obtained in 73% of the cases. We considered 285 patients (97.6%) cured
after their first operation. The remaining seven patients (2.4%) had
persistent hyperparathyroidism. However, five were cured after a
sternum-splitting mediastinal exploration and one after a second neck
exploration. The seventh remains hypercalcemic despite a subsequent
mediastinal exploration. Temporary postoperative hypoparathyroidism
occurred in 10% of our cases and permanent hypoparathyroidism in 1%. There
have been no instances of recurrent hyperparathyroidism.