Effectiveness and safety of 100 consecutive parathyroidectomies

Abstract

Background and methods: In order to evaluate the indications for operation for patients with primary hyperparathyroidism, prospective information was gathered on 100 consecutively operated patients from 1991 to 1996. A standard evaluation for outcomes and patient satisfaction was instituted. Patients consisted of 73 women and 27 men. Major symptoms existed in 48 patients, and 52 patients were referred to as "asymptomatic" because they fit the National Institutes of Health Consensus Development Conference Statement with abnormal laboratory values. The pathology was 94 single adenomas, 4 double adenomas, and 2 cases of hyperplastic multiglandular disease.

Results: All 100 patients had abnormal parathyroids removed, resulting in normocalcemia in 97. Three patients had persistent hypercalcemia until a second operation removed additional abnormal parathyroids, resulting in normocalcemia. No operative complications or mortality occurred. Overnight stay occurred in 88 patients. During long-term follow-up of patients, only 2 developed recurrent hyperparathyroidism. When asked whether the operation improved their health, 94% of patients with major symptoms and 72% of asymptomatic patients responded affirmatively.

Conclusion: Parathyroidectomy is an efficient and safe operation with excellent normalization of serum calcium and a high rate of patient satisfaction.