[Parathyroid surgery in Landakotsspítali 1973-1994.]

Area of Science:

• Endocrinology
• Surgical Pathology
• Oncology

Context:

• Retrospective analysis of 44 operations for primary hyperparathyroidism (PHPT) in 42 patients (1973-1994).
• Landakotsspitali, Reykjavik served as the study location.
• Patients included men and women with varying degrees of hypercalcemia.

Purpose:

• To evaluate the surgical outcomes and complication rates for primary hyperparathyroidism.
• To analyze the histological findings in patients undergoing parathyroid surgery.
• To assess the long-term management of hyperparathyroidism, including recurrent disease and hypocalcemia.

Summary:

• The study reports a high operative success rate (97.7%) with only one reoperation needed for persistent hypercalcemia.
• Histological examination revealed adenomas in 88% of patients, chief cell hyperplasia in 9.5%, and double adenomas in 9.5%. No parathyroid carcinoma was diagnosed.
• Transient postoperative hypocalcemia affected 31 patients, while permanent hypocalcemia occurred in three. One case of vocal cord paralysis was noted. Elevated parathyroid hormone (PTH) was observed long-term in two patients.

Impact:

• Demonstrates the efficacy and safety of surgical intervention for primary hyperparathyroidism.
• Provides insights into the histological spectrum of parathyroid disease, including rare presentations like functioning oxyphil cell adenomas.
• Highlights the importance of monitoring parathyroid hormone levels post-surgery for detecting recurrence or persistent disease.