EXPERIENCES IN PARATHYROID SURGERY

Abstract

in this study we aimed to evaluate the value and importance of localization techniques and surgical approaches to primary hyperparathyroidism. Many centers perform parathyroid surgery with high success rates and low morbidity, Persistent or recurrent hyperparathyroidism that necessitates the second operation increases the morbidity. For this reason the value of preoperative localization techniques and the operative strategy are still controversial and no clear cut consensus was established. 21 neck explorations performed on 20 patients during 1992-1999 was evaluated retrospectively, The sensitivity of Tc 99 m sestamibi scan was found to be 100%. Bilateral neck exploration was performed on 5 patients and unilateral neck exploration, our surgical preference, was performed on 15 patients. In all cases serum total Ca, ionised Ca and parathormone levels were found to decrease significantly postoperatively. Early hypocaicemia was achieved in all cases except the reoperated one. Persistant hypocaicemia was not found, One patient had recurrent nerve palsy. No surgical mortality was reported, We concluded that the preoperative localization techniques were justified in primary hyperparathyroidism patients, US and Tc 99m sestamibi seans are non-invasive, cheap and successful that must be performed primarily. Unilateral approach is fast, safe and successful in localized tumors,