Are concomitant surgical procedures acceptable in patients undergoing cervical exploration for primary hyperparathyroidism?

Abstract

Cervical exploration for primary hyperparathyroidism is an extremely safe procedure with essentially no operative mortality or morbidity and with success rates approaching 98%. These results have encouraged experienced surgeons to perform other surgical procedures concomitantly with cervical exploration with use of the same general anesthetic agent. This retrospective study was performed to assess the safety and efficacy of this practice. At our institution, 117 patients underwent cervical exploration for primary hyperparathyroidism in combination with an additional surgical procedure, including breast (25), biliary (21), gynecologic (19), intra-abdominal (18), and cardiothoracic (6) operations. The mean operative time was 155 minutes, and the mean duration of hospitalization was 7.6 days. Postoperatively, 115 patients (98%) were normocalcemic. Nine complications (mostly minor), which occurred in eight patients, related primarily to the concomitant surgical procedure. No operative mortality occurred. If performed by experienced surgeons in carefully selected patients, cervical exploration for primary hyperparathyroidism in combination with another elective operation is safe and cost-effective.