Summary
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
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
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kristoffersson, A., Boquist, L. & Järhult, J. Persistent hypercalcemia after neck exploration —An analysis of 34 cases. Urol. Res. 14, 323–325 (1986). https://doi.org/10.1007/BF00262384
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00262384