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Review
. 2022 Nov 11;66(5):678-688.
doi: 10.20945/2359-3997000000557.

Surgery for primary hyperparathyroidism

Murilo Catafesta das Neves  1 , Rodrigo Oliveira Santos  1 , Monique Nakayama Ohe  2
Affiliations
Review

Surgery for primary hyperparathyroidism

Murilo Catafesta das Neves et al. Arch Endocrinol Metab. .

Abstract

Primary hyperparathyroidism (PHPT) is a hypercalcemic disorder that occurs when one or more parathyroid glands produces excessive parathyroid hormone (PTH). PHPT is typically treated with surgery, and it remains the only definitive therapy, whose techniques have evolved over previous decades. Advances in preoperative localization exams and the intraoperative PTH monitoring have become the cornerstones of recent parathyroidectomy techniques, as minimally invasive techniques are appropriate for most patients. Nevertheless, these techniques, are not suitable for PHPT patients who are at risk for multiglandular disease, especially in those who present with familial forms of PHPT that require bilateral neck exploration. This manuscript also explores other conditions that warrant special consideration during surgical treatment for PHPT: normocalcemic primary hyperparathyroidism, pregnancy, reoperation for persistent or recurrent PHPT, parathyroid carcinoma, and familial and genetic forms of hyperparathyroidism.

Keywords: Primary hyperparathyroidism; parathyroid hormone; parathyroidectomy; treatment.

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Conflict of interest statement

Disclosure: no potential conflict of interest relevant to this article was reported.

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