[Primary hyperparathyroidism--choice of surgical procedures and follow up after surgery]

Surgery for primary hyperparathyroidism (PHPT) is usually one of the most gratifying of all operations; however, at times, it can be one of the most frustrating. Parathyroidectomy has been practiced for about 70 years. During that time, a great deal of knowledge about the anatomy, embryology, pathology, and physiology of this disease has been acquired. Difficulties in parathyroidectomy for PHPT are due to the variability in the number of parathyroid glands, the different locations of normal and pathologic glands from others that are subtly diseased. To be successful, a parathyroid surgeon must have an excellent knowledge of the anatomy, embryology, and pathophysiology of the parathyroid glands. The results of parathyroid surgery for PHPT in the 1990s are excellent when done by experienced surgeons. These findings strongly advocate special training and interest in parathyroid surgery in order to ensure success.