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April 1983

Subtotal Parathyroidectomy for Primary Hyperparathyroidism: Long-term Results in 292 Patients

Author Affiliations

From the Departments of Surgery (Drs Paloyan, Oslapas, and Hofmann), Medicine (Dr Lawrence), Biochemistry (Drs Lawrence and Hofmann), and Pathology (Dr Shah), Loyola University Stritch School of Medicine, Maywood, Ill, and the Research Service, Veterans Administration Hospital (Drs Paloyan, Lawrence, and Ernst), Hines, Ill.

Arch Surg. 1983;118(4):425-431. doi:10.1001/archsurg.1983.01390040037008

• Subtotal parathyroidectomy was performed in a consecutive series of 292 patients with primary hyperparathyroidism. We evaluated the long-term postoperative results during a period of 16 years. Patients ranged in age from 14 to 83 years and included 176 women and 116 men. Of these, 16% had a history of exposure to radiation in childhood or adolescence, while thyroid disease requiring some form of thyroidectomy coexisted in 91(31%) of the patients. Histologic information on three or more parathyroid glands was obtained in 73% of the cases. We considered 285 patients (97.6%) cured after their first operation. The remaining seven patients (2.4%) had persistent hyperparathyroidism. However, five were cured after a sternum-splitting mediastinal exploration and one after a second neck exploration. The seventh remains hypercalcemic despite a subsequent mediastinal exploration. Temporary postoperative hypoparathyroidism occurred in 10% of our cases and permanent hypoparathyroidism in 1%. There have been no instances of recurrent hyperparathyroidism.

(Arch Surg 1983;118:425-431)