Abstract
To evaluate the efficacy of subtotal parathyroidectomy (STP) in the treatment of primary hyperparathyroidism due to multiple gland disease, 12 patients with multiple endocrine neoplasia (MEN) type I syndrome were reviewed out of 132 patients undergoing parathyroidectomy. Each patient had yearly follow-up examinations and calcium determinations for a minimum of four years except for one patient who died one year after S.T.P. Permanent hypoparathyroidism occurred in three patients. Two patients remained persistently hypercalcemic, and two patients developed recurrent hypercalcemia. One patient required oral administration of calcium and vitamin D for ten years following STP before recurrent hypercalcemia developed. Another patient was normocalcemic for three years before recurrent hypercalcemia was noted. Only five of these 12 patients remain normocalcemic without need of calcium and vitamin D therapy. In patients with MEN type I, the long-term results of STP are less than satisfactory. Not only is it difficult to gauge how viable parathyroid tissue must be left to prevent both permanent hypoparathyroidism and persistent hyperparathyroidism but there is also a long-term risk of recurrence.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Block M. A., Frame B., Jackson C. E. The efficacy of subtotal parathyroidectomy for primary hyperparathyroidism due to multiple gland involvement. Surg Gynecol Obstet. 1978 Jul;147(1):1–5. [PubMed] [Google Scholar]
- Block M. A., Frame B., Kleerekoper M., Rao D. S. Surgical management of persistence or recurrence after subtotal parathyroidectomy for primary hyperparathyroidism. Am J Surg. 1979 Oct;138(4):561–566. doi: 10.1016/0002-9610(79)90419-7. [DOI] [PubMed] [Google Scholar]
- Brennan M. F., Brown E. M., Marx S. J., Spiegel A. M., Broadus A. E., Doppman J. L., Webber B., Aurbach G. D. Recurrent hyperparathyroidism from an autotransplanted parathyroid adenoma. N Engl J Med. 1978 Nov 9;299(19):1057–1059. doi: 10.1056/NEJM197811092991909. [DOI] [PubMed] [Google Scholar]
- Brennan M. F., Doppman J. L., Marx S. J., Spiegel A. M., Brown E. M., Aurbach G. D. Reoperative parathyroid surgery for persistent hyperparathyroidism. Surgery. 1978 Jun;83(6):669–676. [PubMed] [Google Scholar]
- COPE O., KEYNES W. M., ROTH S. I., CASTLEMAN B. Primary chief-cell hyperplasia of the parathyroid glands: a new entity in the surgery of hyperparathyroidism. Ann Surg. 1958 Sep;148(3):375–388. doi: 10.1097/00000658-195809000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cope O. Editorial: Hyperparathyroidism--too little, too much surgery? N Engl J Med. 1976 Jul 8;295(2):100–102. doi: 10.1056/NEJM197607082950209. [DOI] [PubMed] [Google Scholar]
- Edis A. J., van Heerden J. A., Scholz D. A. Results of subtotal parathyroidectomy for primary chief cell hyperplasia. Surgery. 1979 Sep;86(3):462–469. [PubMed] [Google Scholar]
- Geis W. P., Popovtzer M. M., Corman J. L., Halgrimson C. G., Groth C. G., Starzi T. E. The diagnosis and treatment of hyperparathyroidism after renal homotransplantation. Surg Gynecol Obstet. 1973 Dec;137(6):997–1010. [PMC free article] [PubMed] [Google Scholar]
- Haase G. M., Luce J. M., Lock J. P., Hammond W. S., Penn I. Hyperparathyroidism following parathyroid autotransplantation. Surgery. 1979 Nov;86(5):694–697. [PubMed] [Google Scholar]
- Mozes M. F., Soper W. D., Jonasson O., Lang G. R. Total parathyroidectomy and autotransplantation in secondary hyperparathyroidism. Arch Surg. 1980 Apr;115(4):378–385. doi: 10.1001/archsurg.1980.01380040012002. [DOI] [PubMed] [Google Scholar]
- Wells S. A., Jr, Ellis G. J., Gunnells J. C., Schneider A. B., Sherwood L. M. Parathyroid autotransplantation in primary parathyroid hyperplasia. N Engl J Med. 1976 Jul 8;295(2):57–62. doi: 10.1056/NEJM197607082950201. [DOI] [PubMed] [Google Scholar]