Persistent hypercalcemia after neck exploration —An analysis of 34 cases

Urological Research - Tập 14 - Trang 323-325 - 1986
A. Kristoffersson1, L. Boquist2, J. Järhult1
1Department of Surgery (Head: Sven Dahlgren), University Hospital, Umeå, Sweden
2Department of Pathology, University Hospital, Umeå, Sweden

Tóm tắt

A retrospective analysis of 34 patients undergoing 45 re-explorations for persistent hypercalcemia is presented. Thirteen out of the 20 enlarged parathyroid glands were found at reoperation to be normally located, indicating that the initial exploration had been incomplete. A follow-up study of the reoperated patients showed that 25 (74%) were normocalcaemic. Three patients had permanent unilateral recurrent laryngeal nerve damage and 2 patients required calcium and/or vitamin D therapy. Ultrasonography was effective in the diagnosis and localisation of residual parathyroid adenoma in patients with persistent postoperative hyperparathyroidism.

Tài liệu tham khảo

Arima M, Yokoi H, Sonoda T (1975) Preoperative identification of tumor of the parathyroid by ultrasonotomography. Surg Gynecol Obstet 141:242 Billings PJ, Milroy EJG (1983) Reoperative parathyroid surgery. Br J Surg 70:542 Bruining HA, van Houten H, Juttmann JR, Lamberts SWJ, Birkenhäger JC (1981) Results of operative treatment of 615 patients with primary hyperparathyroidism. World J Surg 5:85 Edis AJ, Evans TC Jr (1979) High-resolution real-time ultrasonography in the preoperative location of parathyroid tumors. N Engl J Med 301:532 Granberg PO, Johansson G, Lindvall N, Öhman U, Wajngot A, Werner S, Willems JS (1982) Reoperation for primary hyperparathyroidism. Am J Surg 143:296 Järhult J, Kristoffersson A, Lundström B, Öberg L (1985) Comparison of ultrasonography and computed tomography in the preoperative localization of parathyroid adenomas. Acta Chir Scand 151:583–587 Krudy AG, Doppman JL, Brennan MF, Marx SJ, Spiegel AM, Stock JL, Aurbach GD (1981) The detection of mediastinal parathyroid glands by computed tomography, selective arteriography, and venous sampling. Radiology 140:739 Palmer JA, Rosen IB (1982) Reoperative surgery for hyperparathyroidism. Am J Surg 144:406 Romanus R, Heimann P, Nilsson O, Hansson G (1973) Surgical treatment of hyperparathyroidism. Prog Surg 12:22 Russell CF, Edis AJ, Purnell DC (1983) The reasons for persistent hypercalcaemia after cervical exploration for presumed primary hyperparathyroidism. Br J Surg 70:198 Stark DD, Gooding GAW, Moss AA, Clark OH, Ovenfors C-O (1983) Parathyroid imaging: Comparison of high-resolution CT and high-resolution sonography. AJR 142:633 Wang C-A (1977) Parathyroid re-exploration: a clinical and pathological study of 112 cases. Ann Surg 186:140 Vroonhoven TJ van, Muller H (1978) Causes of failure in the surgical treatment of primary hyperparathyroidism: lessons from 51 successful reoperations. Br J Surg 65:297 Wells SA Jr, Doppman JL, Bilezikian JP et al (1973) Repeated neck exploration in primary hyperparathyroidism: localization of abnormal glands by selective thyroid arteriography, selective venous sampling and radioimmunoassay. Surgery 74:678