Surgical Management of Primary Hyperparathyroidism



Primary hyperparathyroidism (PHPT) is a disease that affects calcium metabolism leading to elevated serum calcium in the presence of an inappropriately normal or high parathyroid hormone (PTH) level. It is a relatively common condition, with prevalence rates reported to be about 1–4 per 1,000 with a female:male ratio of 3:1 and as frequent as 1 in every 500 women over the age of 50 years [1–3]. PHPT is most commonly due to a single parathyroid adenoma (80–85% of cases), but may also be attributable to the presence of multiple adenomas, hyperplasia or malignancy.


Parathyroidectomy Surgical indication Parathyroid cancer Hungry bone disease Hyperparathyroidism Osteitis fibrosa cystica Nephrolithiasis Hypercalcemic crisis Quality of life outcomes Psychiatric assessment tools Surgical approaches Embryology Anatomy Thymus Neck exploration—unilateral Bilateral Parathyroid carcinoma Parathyroid hyperplasia Resection Multi-gland disease Preoperative imaging Minimally invasive parathyroidectomy Image-directed parathyroidectomy Intra-operative PTH assays Miami criterion Surgical success rates Radio-guided parathyroidectomy Gramma probe Endoscopic parathyroidectomy Video-assisted parathyroidectomy Hungry bone syndrome Recurrent disease Persistent disease 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of SurgeryMonash University Endocrine Surgery UnitMelbourneAustralia
  2. 2.Department of Surgery and Oncology, Divisions of General Surgery and Surgical OncologyUniversity of Calgary, North Tower, Foothills Medical CenterCalgaryCanada

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