Results of parathyroidectomy for primary hyperparathyroidism

We have performed 16 operations on 14 patients with primary hyperparathyoidism caused by a solitary parathyroid adenoma in our department between 1st jan. 1990-31 dec. 1999. In each case bilateral neck exploration was carried out. As in one case it was located in ectopic neck position, in the other case papillocarcinoma of the thyroid gland and ectopic parathyroid adenoma in mediastinal position were present, primary hyperparathyroidism persisted, so reoperation was needed. Histological examination proved the presence of adenomin all cases. Diffuse hyperplasia and parathyroid cancer did not occur. Before operation all patients underwent US and seven of them had radionuclide scintigraphy. CT scan aided in its localization with four patients. We did not make use of invasive methods, after the first operation 12 patients showed normal S-Ca levels very quickly. In two cases this level was too high after the operation and reoperation was necessary which resulted in normal Ca levels. Even though the number of our cases is rather modest, all the patients recovered. This may prove that we can successfully cure our patients of modern methods of diagnostics used for meticulous examination alongside with careful preparation of the patients by internal specialists are followed by the standard operative techniques available.