[Current surgical aspect of primary hyperparathyroidism (100 years after F. D. Von Recklinghausen)]

The "Association Française de Chirurgie" asked to authors an update on primary hyperparathyroidism based on a retrospective multicentric study on 4883 patients operated on by 79 surgeons. Aim of this study was an update on clinical and biological aspects, localizing studies, and therapeutic aspects with their results. There were 3418 females (70%) and 1465 males (30%) mean age 53 years (9 to 91 years): 3702 solitary adenomas (75.8%), 720 multi-glandular lesions (14.7%) 92 multiple endocrine neoplasias (1.9%) and 86 carcinomas (1.8%). None lesions was found in 283 cases (5.8%). To day, diagnosis is most often made on fortuitous hypercalcemia. Localising studies showed sensibility less than 50%. Surgery was successful in 92.7%. Mortality occurred in 0.6% hypoparathyroidism in 3.8%, laryngeal palsy in 1.5% and hematomas in 0.45%. In conclusion this study shows the changes regarding the diagnosis, the uselessness of localizing studies before first cervicotomy, and the good results of surgery. Autotransplantation and cryopreservation allow reducing of hypoparathyroidism.