LONG-TERM RESULTS OF UNILATERAL NECK EXPLORATION FOR PREOPERATIVELY LOCALIZED NONFAMILIAL PARATHYROID ADENOMAS

BACKGROUND: Unilateral neck exploration for sporadic parathyroid adeno mas remains a contentious policy. The morbidity is lower than for bila teral surgery, but the long-term outcome may be inferior. METHODS: The results of a policy of unilateral neck exploration for primary hyperp arathyroidism based on preoperative localization are reviewed. RESULTS : Over a 10-year period, 89 patients were operated on, 57 undergoing u nilateral neck exploration. Unilateral neck exploration significantly reduced operative time (P <0.0001) and postoperative hypocalcaemia (P = 0.021). Over a mean biochemical follow-up of 38 months, recurrent hy percalcaemia occurred in 6% of patients, including 3.5% of those under going unilateral neck exploration, an additional 10% of patients were normocalcaemic with an inappropriately elevated parathormone level. CO NCLUSIONS: A policy of unilateral neck exploration can achieve compara ble long-term results to more extensive bilateral surgery.