Beyond the Scale: Exploring Parathyroidectomy Outcomes in Super Obesity (BMI ≥ 50)

Super obesity (body mass index ≥50) poses unique surgical challenges; however, its impact on parathyroidectomy outcomes is unexplored. This study examines surgical risks, recovery, and success rates in super-obese patients undergoing parathyroidectomy.

A retrospective cohort of 3206 patients (84 super-obese, 3076 nonsuper-obese) who underwent parathyroidectomy from 2000 to 2024 was analyzed. Outcomes included complications, cure rates, and preoperative and/or postoperative laboratory values.

Super-obese patients were younger (54.7 ± 1.4 versus 58.8 ± 0.3 years, P = 0.01) with lower preoperative vitamin D levels (26.7 ± 2.0 versus 32.7 ± 0.3 ng/mL, P < 0.001). They had higher rates of double adenomas (18.1% versus 10.5%, P = 0.03), malignancies (3.6% versus 0.1%, P < 0.001), and inpatient stays (11.5% versus 3.5%, P = 0.03). Complication rates and cure rates were similar between groups.

Parathyroidectomy is safe in super-obese patients at high-volume centers, although pathologies are unique and inpatient admissions are more common.