A systematic approach to parathyroid surgery

Abstract
In the last 8 years 33 patients with hyperparathyroidism have been surgically treated by the authors. Thirty patients had primary, 2 secondary and 1 tertiary hyperparathyroidism. In the 30 patients with the primary disorder, 26 had a single adenoma and 28 of these patients had normal calcium levels postoperatively. Two patients were hypocalcaemic following surgery and required calcium supplements for 3 months and 9 months respectively. It is recommended that when a single adenoma is found its removal will render the patient normocalcaemic. When all 4 glands are hyperplastic the surgery should be subtotal (3 1/2 glands) parathyroidectomy except in the case of secondary hyperparathyroidism when total parathyroidectomy with autotransplantation and cryopreservation of the remainder should be performed.