A surgical approach to primary hyperparathyroidism, 1971-1976

Forty-two patients with primary hyperparathyroidism were seen in Auckland Hospital between 1971-1976. These patients were reviewed as to age, sex, mode of presentation, pathology and location of lesions. All were treated surgically. There were two deaths due to severe hypercalcaemia. The value of parathyroid hormone assay and neck vein catheterisation is assessed. The practical aspects of neck exploration for hyperparathyroidism are outlined. The two problems of the treatment of chemical hyperparathyroidism and the recognition and treatment of parathyroid hyperplasia are discussed.