Reoperative parathyroid surgery for persistent hyperparathyroidism

M. F. Brennan, J. L. Doppman, S. J. Marx, A. M. Spiegel, E. M. Brown, G. D. Aurbach

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69 Scopus citations

Abstract

In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56%, and retrospectively was correct in 63%. Selective venous catheterization gave localizing information in 83%, correctly predicting site or side in 60% of the total. Computerized axial tomography was helpful in identifying mediastinal glands before operation. Reoperation was successful in rendering the patient hypocalcemic or normacalcemic in 83%. Of the 11 patients (37%) who were rendered profoundly hypocalcemic, two were subsequently weaned from vitamin D and calcium support; seven have received either fresh or cryopreserved parathyroid autografts. Persistent hyperparathyroidism is a difficult surgical problem which we believe warrants aggressive localization attempts prior to operation. Autotransplantation with cryopreserved parathyroid tissue may be of value in the long-term management of the high incidence of postoperative hypocalcemia in this patient group.

Original languageEnglish (US)
Pages (from-to)669-676
Number of pages8
JournalSurgery
Volume83
Issue number6
Publication statusPublished - Dec 1 1978
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Brennan, M. F., Doppman, J. L., Marx, S. J., Spiegel, A. M., Brown, E. M., & Aurbach, G. D. (1978). Reoperative parathyroid surgery for persistent hyperparathyroidism. Surgery, 83(6), 669-676.