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Complications to subtotal parathyroidectomy

B Anderberg, J Gillquist, L Larsson

    Acta Chirurgica Scandinavica
    |January 1, 1981
    PubMed
    Summary
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    Biopsies for identifying parathyroid glands during surgery for hyperparathyroidism, including subtotal resection for hyperplasia, did not increase complication risks. Most patients achieved normal calcium levels long-term post-operation.

    Area of Science:

    • Endocrinology
    • Surgical Pathology
    • Oncology

    Background:

    • Hyperparathyroidism necessitates surgical intervention to manage calcium imbalances.
    • Accurate gland identification and appropriate resection are crucial for successful surgical outcomes.
    • Potential complications include hypocalcemia and persistent hyperparathyroidism.

    Purpose of the Study:

    • To evaluate the safety and efficacy of using 1/3 biopsies for parathyroid gland identification during hyperparathyroidism surgery.
    • To assess the complication rates associated with parathyroid gland biopsies and subtotal resection in hyperplasia cases.
    • To determine the long-term normocalcemic status of patients following these surgical techniques.

    Main Methods:

    • Seventy-three patients with confirmed hyperparathyroidism underwent surgery.

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  • Parathyroid glands were identified using 1/3 biopsies for frozen section histopathology.
  • Adenomas were removed except for biopsies; hyperplasia cases underwent subtotal resection, leaving 0.5-1 gland.

    • Main Results:

    • Temporary hypocalcemia rates were similar in adenoma and hyperplasia groups.
    • Only one patient experienced permanent hypocalcemia.
    • At 3-5 years post-operation, 98.6% of patients were normocalcemic, with normalized serum calcium, phosphate, magnesium, and parathormone levels.

    Conclusions:

    • Parathyroid gland identification via biopsies does not elevate postoperative complication risks.
    • Subtotal parathyroidectomy in hyperplasia cases is a safe and effective approach.
    • The described surgical methods ensure long-term normocalcemia and biochemical stability.