Outcomes of Focused Parathyroidectomy in Hyperparathyroidism

To evaluate the surgical outcome of focused parathyroidectomy (FP) in the management of hyperparathyroidism.

A case series. Place and Duration of the Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi, Pakistan, from September 2018 to December 2024.

The study included 52 patients with primary hyperparathyroidism due to parathyroid adenoma who underwent FP during the study period. The recorded data included age, gender, pre- and postoperative calcium levels, pre- and postoperative parathyroid hormone (PTH) levels, preoperative localisation, and complications. The normalisation of post-operative PTH levels and serum calcium levels determined successful surgery. IBM SPSS version 26 was used as the data analysis tool.

A total of 52 patients with a mean age of 45 years (40.4%) were included. Seventeen (32.7%) were male, and 35(67.3%) were female. All patients had elevated PTH levels, with a mean of 200.5 pg/mL (range 100-700) and a preoperative calcium level of 10.5 mmol/L (range 6-20). Preoperative ultrasonography, CT scan of the neck, and MIBI scan were used to localise the adenoma in all patients, with an average size of 1.6-2cm. Twenty-five (48.1%) patients had a parathyroid adenoma in the left inferior pole. After 3 months of follow-up, all patients had decreased serum PTH and calcium levels by more than 50% preoperative values.

FP with accurate preoperative localisation has an excellent cure rate with minimal morbidity and is the treatment of choice, replacing bilateral neck exploration.

Parathyroidectomy, Parathyroid neoplasms, Primary hyperparathyroidism, Endocrine surgical procedures.