Surgical therapy of primary hyperparathyroidism, and it's complications. Experience with 453 patients
Abstrakt
453 patients underwent surgery for primary hyperparathyreoidism between 1994 and 2003. In all patients, biochemical parameters were monitored and X-ray with USG of the neck was done.
Struma nodosa was concommitantly present in 48% of treated patients with primary hyperparathyroidism. In such cases, MRI offers better resolution of soft tissues. 98.6% of treated patients had postoperative decrease of blood calcium to normal level. 5.4% of cases were reoperations for primary hyperparathyroidism.
In 12% of cases, pathologically changed parathyroid glands in dystopic localization were found. In these dystopic localizations, pathologic parathyroid glands were found: in 3% intrathyroid, in 7% mediastinal and in 2% of all 453 cases in other localization.
In 4% of patients, sternotomy was necessary. Persistent hypocalcemia was not registered in any patient.
Transient hypocalcemia with necessity of infusion therapy was observed in 3.5 % of patients. Postoperative hypercalcemia persisted in 1.2% of patients.
Recurrent hypercalcemia was present in 0.2% of cases. In three cases (0.7%), unilateral injury of recurrent laryngeal nerve was observed.