World Journal of Surgery

, Volume 31, Issue 6, pp 1204–1211 | Cite as

Effect of Parathyroidectomy on Quality of Life and Neuropsychological Symptoms in Primary Hyperparathyroidism

  • Theresia Weber
  • Monika Keller
  • Isabella Hense
  • Alexander Pietsch
  • Ulf Hinz
  • Tobias Schilling
  • Peter Nawroth
  • Ernst Klar
  • Markus W. Büchler


Neuropsychological symptoms are found in a certain number of patients with primary hyperparathyroidism (PHPT). Preoperative and postoperative quality of life, anxiety, and depression are measured to analyze the impact of parathyroidectomy on these symptoms. In this prospective study, 66 patients underwent parathyroidectomy for PHPT and were evaluated pre- and postoperatively with two validated psychometric instruments (HADS, PHQ-9). Health-related quality of life was measured with a 12-item short-form health survey (SF-12). Preoperatively, the median physical component score (SF-12) of 43.0 and mental component score of 43.5 were lower than those of the general population (52.8 and 54.2 points, respectively). One year postoperatively the mental component score increased to 48.6 (p = 0.011), whereas the physical functioning scale scored 45.3 and therefore did not change significantly (p = 0.585). Preoperatively, symptoms of depression were found in 23.4% of the patients, and 15.6% of the patients displayed symptoms of anxiety (HADS). The prevalence of depression was significantly higher in patients with preoperative serum calcium levels > 11.2 mg/dl (2.8 mmol/L) (p = 0.015). Twelve months postoperatively, the overall proportion of patients with anxiety and depression decreased to 7.8% and 15.7%, respectively (p = NS). The severity of depression as measured with the PHQ-9 declined postoperatively as well. In this study, preoperative neuropsychological symptoms were related to the serum calcium levels. Postoperative health-related quality of life improved significantly. Among patients with preoperative symptoms of depression and anxiety, both symptoms were alleviated significantly at the 12-month follow-up. Therefore, surgery for PHPT seems to be effective in reducing neuropsychological morbidity associated with PHPT.


Parathyroid Adenoma Serum Calcium Level Parathyroid Carcinoma Mental Component Score Physical Component Score 
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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Theresia Weber
    • 1
  • Monika Keller
    • 2
  • Isabella Hense
    • 1
  • Alexander Pietsch
    • 3
  • Ulf Hinz
    • 1
  • Tobias Schilling
    • 4
  • Peter Nawroth
    • 4
  • Ernst Klar
    • 3
  • Markus W. Büchler
    • 1
  1. 1.Department of SurgeryUniversity of HeidelbergHeidelbergGermany
  2. 2.Department of Psychosomatic MedicineUniversity of HeidelbergHeidelbergGermany
  3. 3.Department of SurgeryUniversity of RostockRostockGermany
  4. 4.Department of Internal Medicine IUniversity of HeidelbergHeidelbergGermany

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