REOPERATIVE PARATHYROID SURGERY

Abstract

In this study success rate of surgery in patients with persistent or recurrent primary hyperparathyroidism (HPT), operative morbidity and mortality together with sensitivity and specificity of preoperative localizing studies were analysed. 10 patients had a history of 11 primary or secondary operations. There were nine women and one man. The mean age was 42.8 (range: 19-78). Seven out of ten patients were referred to our department with persistent hyperparathyroidism which had been operated on in other centers. Three patients have been operated on by the same operative team of our department (two persistent and one recurrent HPT patient). There was no peroperative and postoperative mortality, no postoperative morbidity. One patient remained with persistent HPT, thus operative success rate was found to be 90%. Sensitivity (Sn) and specificity (Sp) of preoperative localizing sutudies were as follows. Ultrasound Sn: 60%, Sp; 60%, Magnetic Resonance Imaging Sn: 80%, Sp; 80%, Technetium 99m sesta MIBI scintigram Sn: 70%, Sp;70%.

In conclusion, it has been our experience, that though limited number of patients, it seems possible to cure 90% of the persistent or recurrent primary HPT patients with the help of preoperative localizing studies and a meticulous surgical technique.