[Parathyroid surgery in Landakotsspítali 1973-1994.]

The results of 44 operations on 42 patients (nine men and 33 women) for primary hyperparathyroidism in Landakotsspitali, Reykjavik during the period 1973-1994 were studied. Only one patient needed reoperation because of persistent hypercalcemia. The operative success rate is 97.7%. One patient had two recurrent single adenomas with an interval of three years during which the patient was normocalcemic. Two patients were diagnosed having multiple endocrine neoplasia type I (MEN) before the operation. One of those had a brother with parathyroid carcinoma. Hyperparathyroidism was histologically verified in all 42 patients. Thirtyseven (88%) had adenoma, and four (9.5%) had chief cell hyperplasia. Double adenomas were diagnosed in four patients (9.5%). In two patients functioning oxyphil cell adenomas were encountered. One case (2.4%) could not be histologically sub typed. This patient had a brother who died of parathyroid carcinoma. One patient with type I MEN syndrome had adenoma, the other had chief cell hyperplasia. No parathyroid carcinoma was diagnosed. Thirtyone patients needed medical treatment for transient postoperative hypocalcemia. Permanent hypocalcemia was found in three patients. Vocal cord paralysis was recorded in one case. No other complication was found. Two patients had elevated parathyroid hormone (PTH), both nine years after the operation. One of those is normocalcemic and without symptoms, the other hypocalcemic for unexplainable reasons.