Results of Surgical Treatment of Primary Hyperparathyroidism

The article presents a retrospective and prospective analysis of treatment results in 76 patients with typical clinical manifestations of primary hyperparathyroidism being treated as inpatients in Ivano-Frankivsk Regional Clinical Hospital from 2010 to 2015. There were 24 (77.0%) females and 7 (23.0%) males. Various forms of hyperparathyroidism were diagnosed in 31 (40.7%) patients. Surgery was performed in all patients under general anesthesia with cervical access. Bilateral exploration of the parathyroid glands with the removal of modified adenomatous and hyperplastic glands were performed. One parathyroid gland was removed in 22 (73.0%) patients; two parathyroid glands were removed in 9 (17.0%) patients. 14 (45.2%) patients were diagnosed with renal form of primary hyperparathyroidism, 8 (25.8%) patients were diagnosed with mixed form of primary hyperparathyroidism; 6 (19.4%) patients were diagnosed with osseous form of primary hyperparathyroidism and asymptomatic form was diagnosed in 3 (9.7%) patients. After surgery 2 (6.4%) patients developed severe transient hypoparathyroidism including paresthesia and spasms which required intravenous injection of calcium for 4-5 days with further administration of its tablet form for 2-3 months. All operated patients with renal form of primary hyperparathyroidism shortly before parathyroidectomy or immediately after it underwent extracorporeal lithotripsy or kidney surgery. In 10 patients of this group the indicators of phosphorous-calcium metabolism were normalized. In one patient two months after parathyroidectomy a slight increase in the level of parathyroid hormone was preserved - by 72.4 pg/ml. Thus, 2 months after surgery the level of parathyroid hormone exceeded the normal values in one patient (4.2%) only.