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July 1973

Parathyroidectomy for Hyperplasia in Renal Disease

Author Affiliations

Los Angeles
From the Department of Anatomic Pathology, Division of Surgery, Cedars-Sinai Medical Center, Los Angeles.

Arch Surg. 1973;107(1):51-55. doi:10.1001/archsurg.1973.01350190039011

Twenty-seven patients with parathyroid hyperplasia secondary to renal failure have had parathyroidectomy. Normally 3¾ of the parathyroid glands were removed. There were 12 women and 15 men with a mean age of 36.8 years and a median age of 34 years. Ten patients (37%) required some mediastinal dissection to locate and remove the lower parathyroid glands. Three patients (11%) required early reoperation for bleeding. Two patients had functioning renal transplants preoperatively and two had successful postoperative renal transplants. Ten of the patients (37%) had "adenomatous-like" masses within the hyperplastic glands. These should be designated as "adenomas" occurring in hyperplasia. The cooperative team approach of the surgeon and the pathologist is a vital factor in successful parathyroid surgery.