SURGICAL-TREATMENT OF PRIMARY HYPERPARATHYROIDISM

One hundred and two patients with primary hyperparathyroidism underwen t a total of 108 bilateral neck explorations with attempted identifica tion and biopsy of all four glands. Hypercalcaemia was surgically elim inated in 97 of 102 patients (95%). Of the remaining hypercalcaemic pa tients one was cured by percutaneous ethanol injection and one was reo perated and cured in another hospital. Three patients with persistent hypercalcaemia refused reoperation. Transitory hypocalcaemia with a me dian duration of 15 days was found in 36 patients, and permanent hypoc alcaemia in two patients (1.9%). Permanent paralysis of the recurrent nerve occurred in three patients (2.9%). Twenty-one patients developed other postoperative complications from which they all recovered witho ut sequelae. No postoperative deaths occurred. Our results show that s urgical treatment of primary hyperparathyroidism - including bilateral neck exploration and attempted biopsies of all parathyroid glands - i s safe with a high cure rate.