World Journal of Surgery

, Volume 40, Issue 3, pp 595–599 | Cite as

Location Frequency of Missed Parathyroid Glands After Parathyroidectomy in Patients with Persistent or Recurrent Secondary Hyperparathyroidism

  • Manabu OkadaEmail author
  • Yoshihiro Tominaga
  • Takayuki Yamamoto
  • Takahisa Hiramitsu
  • Shunji Narumi
  • Yoshihiko Watarai
Original Scientific Report



Reoperative parathyroidectomy (RPTX) because parathyroid glands have been missed is frequently required in patients with secondary hyperparathyroidism (SHPT). The usual locations of these missed glands in patients with SHPT are yet to be fully elucidated.


We retrospectively investigated the locations of missed glands in 165 patients who underwent RPTX for persistent or recurrent SHPT at our institution from August 1982 to July 2014. At our institution, total parathyroidectomy with forearm autograft is the routine operative procedure for SHPT. We also routinely resect the thymic tongue.


Of 165 patients, 82 underwent initial parathyroidectomy at our institution (Group A), and the remaining 83 underwent initial parathyroidectomy at other institutions (Group B). A total of 239 parathyroid glands were resected (Group A, 93; Group B, 146). Missed glands were most commonly located in the mediastinum (Group A, 22/93) and the thymic tongue (Group B, 31/146).


In patients with persistent or recurrent SHPT, ectopic parathyroid glands are frequently located in the mediastinum and thymic tongue. Therefore, resecting the thymic tongue during the initial operation may reduce the need for RPTX.


Chronic Kidney Disease Parathyroid Gland Secondary Hyperparathyroidism Parathyroid Tissue Total Parathyroidectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Manabu Okada
    • 1
    Email author
  • Yoshihiro Tominaga
    • 1
  • Takayuki Yamamoto
    • 1
  • Takahisa Hiramitsu
    • 1
  • Shunji Narumi
    • 1
  • Yoshihiko Watarai
    • 1
  1. 1.Department of Transplantation and Endocrine SurgeryNagoya 2nd Red Cross HospitalNagoyaJapan

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