[Unilateral versus bilateral neck exploration in the surgery of primary hyperparathyroidism]

The aim of this study is to know the indications, advantages and disadvantages of a unilateral neck exploration versus bilateral in the primary hyperparathyroidism (HPT) surgery. Since april 1990 to april 2002 we have operated 80 patients diagnosed of HPT. They where divided in different groups in function of the results of the clinic exploration intact paratohormone results (PTHi turbo). In 48 patients (60%) we have done an unilateral cervical surgical exploration (in 9 cases we have determined the PTHi turbo) with good postoperative results. In 32 patients we have realised a bilateral exploration with exposition of both recurrent nerves, based on the discordance between the image exploration and because we were not able to have the intro-operative dose of turbo of PTHi, which use parameter we defend because of its contrasted efficiency, with less surgical time and less iatrogenic possibilities.