Endosonography in the localization of parathyroid tumors: a preliminary study.

A preoperative transesophageal exploration of the parathyroids by endosonography was performed on 23 patients with primary hyperparathyroidism. The system used was a 7.5 MHz transducer mounted on the tip of an endoscope with an external diameter of 13 mm.

[Bone density after iatrogenic subclinical long-term thyrotoxicosis. Measurement by dual photon absorptiometry].

Thyrotoxicosis may be held responsible for osteoporosis. The question is whether a very slight subclinical hyperthyroidism, as is desirable in the post-operative treatment of differentiated thyroid carcinoma, can in the long run be detrimental to bone tissue. In a series of 37 patients, aged 50.

Results of reoperations for persistent or recurrent secondary hyperparathyroidism in hemodialysis patients.

Among 258 patients operated on for secondary hyperparathyroidism (HPT II) from 1971 to 1988, a total of 33 had one or more reoperations for persistent or recurrent HPT II. These reoperations did not induce any mortality or significant morbidity. After inadequate parathyroidectomy (25 cases), 15 patients were reoperated.

[Obligatory parathyroid autotransplantation in thyroid surgery].

In a series of 301 bilateral thyroidectomies carried out over a 6 month period, immediate parathyroid autotransplantation was performed in 44 patients, i.e. 14.

[Surgery of the adrenal glands in Sipple's syndrome. Apropos of 8 cases].

In a series of 82 pheochromocytomas operated on, the authors report 8 cases of Sipple's syndrome, currently classified by Steiner among the type II multiple endocrine neoplasia (MEN II). Six patients were operated on, the mean follow up being 4 years. These patients all underwent total thyroidectomy and 4 of them total bilateral adrenalectomy.

The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side.

In 6307 cervicotomies for thyroid and parathyroid excision, 33 cases of nonrecurrent inferior laryngeal nerve were identified (0.52%). The anomaly was observed in 31 cases from 4921 dissections on the right side (0.

[Surgical treatment of secondary hyperparathyroidism in hemodialyzed patients with chronic renal failure. Results and choice of a technic].

Results are reported of surgical treatment of hyperparathyroidism secondary to chronic renal failure in 231 patients who had undergone 250 operations over 16 years: 152 total parathyroidectomies associated in 151 cases with an autotransplant, 58 subtotal parathyroidectomies, 9 incomplete parathyroidectomies, I white cervicotomy and 39 repeat operations for persistent or recurrent hyperparathyroidism. Results were evaluated clinically, biologically and radiologically after a mean follow up of 4 years, and were rated good in 71.4% of cases.

[Surgery of Conn's syndrome. Apropos of 16 cases].

Operation for tumors responsible for a Conn's syndrome was performed in 16 patients, 11 women and 5 men, over a period of 13 years, the average time before diagnosis being 5 1/2 years. All patients presented hypertension, permanent in 14 and paroxysmal in 2 cases while blood potassium levels were below 3 mmol/l in all patients. Diagnosis was confirmed by elevation of plasma aldosterone and of urine tetrahydroaldosterone, associated with low plasma renin activity not responding to a stimulus.

[The nonrecurrent inferior laryngeal nerve. Apropos of 19 cases including 2 on the left side].

Nineteen cases of non-recurrent inferior laryngeal nerve were identified during 3791 cervicotomies for thyroid or parathyroid excision over the last 7 years, the nervous anomaly being of vascular anomaly origin in all cases. Predisposing factors for its onset during aortic arch development are discussed, together with possible symptomatology and means for preoperative diagnosis. Frequency in the cases reported was 0,54% from 3098 dissections on the right and 0,07% from 2846 dissections on the left.

[Differentiated thyroid cancers. Thyroid recurrence after limited surgery].

Twenty-eight patients with differentiated thyroid cancer presented with local relapse 6 months to 24 years (mean: 7 years) after limited surgery. The tumour was clinically undetectable in 7 cases. Among 22 patients reoperated upon, one died post-operatively, 17.

[Our experience with autotransplantation and cryopreservation of parathyroid tissue in thyro-parathyroid surgery].

Results are reported of four and a half years of experience with autotransplantation and cryopreservation of parathyroid tissue in thyro-parathyroid surgery. One hundred patients with hyperparathyroidism secondary to renal insufficiency were treated by total parathyroidectomy and partial autotransplantation, immediate in 98 cases and secondarily using their frozen stored tissue in the other two cases. Results were compared with those in 13 other patients treated during the same period by subtotal parathyroidectomy.

[Parathyroid autotransplantation during expanded total thyroidectomy for cancer].

Autotransplantation of the parathyroid gland was performed in 28 out of 95 patients undergoing total thyroidectomy for carcinoma. The autotransplantation was supplementary in 15 patients who kept at least one parathyroid gland in the neck and substitutive in 12 patients who had total cervical parathyroidectomy. After 1 to 30 months' follow-up none of these patients had signs of hypoparathyroidism.