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Surgical Experience

Jonathan A. van Heerden, MB, FRCS(C); Raleigh B. Kent, III, MD; Glen W. Sizemore, MD; Clive S. Grant, MD; William H. ReMine, MD

Arch Surg. 1983;118(5):533-536.

Abstract
• Forty-five patients with biochemically documented primary hyperparathyroidism as part of multiple endocrine neoplasia syndrome types 1 or 2 were surgically treated from 1960 through 1980. Hyperplasia occurred in 69% of the patients, single adenoma in 27%, and double adenomas in 4%. All but two patients with hyperplasia underwent subtotal parathyroidectomy. In this group, the cure rate was 93% and the incidence of permanent postoperative hypoparathyroidism 23%. In the adenoma group, treatment included excision of the adenoma and biopsy of at least one other gland. The cure rate was 76%, with no postoperative hypoparathyroidism. Analysis of patients with persistent hyperparathyroidism suggested that failure to recognize multiple gland disease was the principal cause of postoperative hypercalcemia. In view of the high incidence of hypocalcemia after subtotal parathyroidectomy, approximately 500 mg of tissue should be cryopreserved to allow transplantation should hypocalcemia ensue postoperatively.

(Arch Surg 1983;118:533-536)

Author Affiliations
From the Department of Surgery (Drs van Heerden, Kent, Grant, and ReMine) and Internal Medicine (Dr Sizemore), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication Jan 3, 1983.

Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 15, 1982.

Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr van Heerden).

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