Surgical experiences of hyperparathyroidism

الملخص EN

Objectives : This retrospective article reports the diagnostic experiences of forty six cases of hyperparathyroidism confirmed by operation and pathologic examination.

Methods : From for hyperparathyroidism were investigated.

Eleven surgeons performed the operations by doing only 1 up to 18 procedures.

Experience of surgeon and the result of frozen section were determined adequacy of procedure and completeness of operation.

Results : The clinical presentation was divided into four type : 24 cases (52.17 %) with bone resorption : 15 case (32.60 %) with bone lesions plus urinary calculus : 4 cases (8.69 %) with urinary calculus and 3 cases (6.52 %) with asymptomatic hypercalcemia.

The mean age of 46 patients (35 women, 11 men) was 44 (rang 1 month to 67) years.

Mean preoperative serum calcium was 13 (range 10.5 to 30) mg / 100ml.

Two patients had chronic renal failure.

Neck sonography was done in 18 and parathyroid (Sestamibi) scan was done in 3 with accuracy of 66.66% and 100% subsequently.

The pathological diagnosis was parathyroid adenoma in 37, hyperplasia in 5, parathyroid carcinoma in 1 and negative exploration in 3.

Conclusion : The clinical picture of PHPT in south of Iran is similar to that recognized previously in west.

We are expected routine measurement of serum calcium and highly suspicious of physician in patients with symptoms of musculoskeletal system or renal stone can lead to early diagnosis.

By using parathyroid scan and sonography of neck localization of most parathyroid adenoma is possible.

Therefore minimal access adenomectomy can be replaced conventional neck exploration