Parathyroid Hormone Venous Sampling Before Reoperative Surgery in Renal Hyperparathyroidism

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Abstract
Even in experienced medical centers, the failure and complication rates of reoperative parathyroid surgery are markedly increased compared with those of initial operations because of scarring of the tissue planes. Therefore, preoperative localization studies are mandatory before surgery for persistent or recurrent hyperparathyroidism (HPT) to minimize the surgical effort and the complication rate and to minimize the number of nerves at risk. This is particularly true for patients with persistent secondary renal HPT in whom extensive bilateral preparation of the neck was performed during adequate initial surgery.