Results of reoperation for persistent and recurrent hyperparathyroidism

M. F. Brennan, S. J. Marx, J. Doppman, J. Costa, A. Saxe, Allen M. Spiegel, A. Krudy, G. Aurbach

Research output: Contribution to journalArticle

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Abstract

Between August 1975 and January 1981, 106 patients thought to have persistent or recurrent hyperparathyroidism underwent a total of 108 parathyroid re-explorations at the National Institutes of Health. These 106 patients had a total of 175 previous operations for hyperparathyroidism (156 cervical and 19 mediastinal). Nephrolithiasis (54% of patients) and bone disease (24% of patients) were the predominant symptoms. Arteriographic examination and selective venous sampling provided highly accurate localizing results in 33% of the patients, and were of some help in 64%. The final diagnoses after reoperation and re-evaluation were: single-gland disease in 58 patients, primary nonfamilial hyperplasia in 19 patients, familial hyperplasia in three patients, multiple endocrine neoplasia (MEN) Type I in ten patients, MEN Type II in two, parathyroid carcinoma in four patients, secondary hyperplasia in three patients, and familial hypocalciuric hypercalcemia (FHH) in two patients. The diagnosis was in doubt in five patients. In the 95 patients with unequivocal hyperparathyroidism, not due to parathyroid carcinoma, surgery eliminated hypercalcemia in 91 (96%). Two patients died after operation, one of disseminated candidiasis, and one patient, with an immunodeficiency, of sepsis. Five patients developed temporary, and one permanent, recurrent nerve damage; 41% of the patients were hypocalcemic, at the time of discharge from the hospital.

Original languageEnglish (US)
Pages (from-to)671-676
Number of pages6
JournalAnnals of Surgery
Volume194
Issue number6
StatePublished - 1981
Externally publishedYes

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Hyperparathyroidism
Reoperation
Hyperplasia
Parathyroid Neoplasms
Multiple Endocrine Neoplasia
Multiple Endocrine Neoplasia Type 1
Nephrolithiasis
Candidiasis
Bone Diseases
National Institutes of Health (U.S.)
Hypercalcemia

ASJC Scopus subject areas

  • Surgery

Cite this

Brennan, M. F., Marx, S. J., Doppman, J., Costa, J., Saxe, A., Spiegel, A. M., ... Aurbach, G. (1981). Results of reoperation for persistent and recurrent hyperparathyroidism. Annals of Surgery, 194(6), 671-676.

Results of reoperation for persistent and recurrent hyperparathyroidism. / Brennan, M. F.; Marx, S. J.; Doppman, J.; Costa, J.; Saxe, A.; Spiegel, Allen M.; Krudy, A.; Aurbach, G.

In: Annals of Surgery, Vol. 194, No. 6, 1981, p. 671-676.

Research output: Contribution to journalArticle

Brennan, MF, Marx, SJ, Doppman, J, Costa, J, Saxe, A, Spiegel, AM, Krudy, A & Aurbach, G 1981, 'Results of reoperation for persistent and recurrent hyperparathyroidism', Annals of Surgery, vol. 194, no. 6, pp. 671-676.
Brennan MF, Marx SJ, Doppman J, Costa J, Saxe A, Spiegel AM et al. Results of reoperation for persistent and recurrent hyperparathyroidism. Annals of Surgery. 1981;194(6):671-676.
Brennan, M. F. ; Marx, S. J. ; Doppman, J. ; Costa, J. ; Saxe, A. ; Spiegel, Allen M. ; Krudy, A. ; Aurbach, G. / Results of reoperation for persistent and recurrent hyperparathyroidism. In: Annals of Surgery. 1981 ; Vol. 194, No. 6. pp. 671-676.
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