[Late results from patients with operated primary hyperparathyreoidism (mainly renal manifestation) (author's...

By means of folow up of patients with operated primary hyperparathyreoidism (mainly renal manifestation) therefore neck exploration should be done on a broader scale and also the late results are reported. They indicate that a carefully considerated neck exploration is relatively free of risk. Of permanent postoperative complications in 83 operations made upon 76 patients only one case of a permanent unilateral paralysis of the recurrent laryngeal nerve was observed. The patients were subjectively free of symptoms; in the successfully operated patients stone recurrence or increase respectively growth of already existing urinary stones did not occur postoperatively. Those patients in whom repeatedly renal stones had been evident at the time of the operation, reported increased colics with partly spontaneous discharge of stones shortly after the operation; the i.v.p. controls showed no recurrent or additional formation of urinary stones in the patients, where we did successful neck exploration. The comparisons of the pre- and postoperative calcium levels indicate that the aim of the operation, normalisation of the calcium metabolism was obtained in almost all cases; only in 3 patients a hypercalcaemia remained. Mediastinotomy was performed only for two times. From these follow up we conclude that neck exploration carries a little risk compared to the high morbidity of primary hyperparathyreoidism (renal manifestation). Therefore neck exploration should be done on a broader scale and also in cases of diagnostic borderline values.