SURGICAL MANAGEMENT OF PRIMARY HYPERPARATHYROIDISM / 解放军医学杂志

ABSTRACT

To study the surgical management of primary hyperparathyroidism, we analysed 30 patients with primary hyperparathyroidism operated in our hospital from 1981 to 1990. A low collar transverse incision was done in all patients. A single parathyroid adenoma was found in 28 patients,and in 3 cases there were ectopic glands (1 in the mediastinum 2 intrathyroid). The adenoma was removed in all patients.In 1 case there was parathyroid hyperplasia, but only one gland was involved and it was excised. 1 case was diagnosed as parathyroid carcinoma which was located in the tracheo esophageal groove and had invaded the trachea and esophagus. An en bloc resection and tracheostomy were performed. 25 cases were followed up(including 1 case with parathyroid hyperplasia and 1 case with carcinoma) from 8 months to 19 years, there was no recurrence.These results suggest surgical management is the most effective treatment for primary hyperparathyroidism. Removal of the parathyroidoma and unilateral cervical exploration are adequate for the patients with parathyroid adenoma. Bilateral exploration is necessary when parathyroid hyperplasia is found. An en bloc resection is necessary for parathyroid carcinoma.