AI Article Synopsis
- A study of 14 patients with persistent or recurrent primary hyperparathyroidism revealed successful reoperations in 13 cases, primarily due to prior surgeries by inexperienced surgeons.
- Among patients who underwent proper surgical intervention, the causes of persistent hyperparathyroidism were identified as primarily adenomas or hyperplastic glands.
- Preoperative localization, especially using 201-Tl/99m-Tc-subtraction scintigraphy, proved effective in accurately targeting both cervical and mediastinal anomalies, highlighting the importance of skilled surgical practice.
Article Abstract
We report on 14 patients suffering from persistent (n = 13) and truly recurrent (n = 1) primary hyperparathyroidism. Reoperations were successful in 13 cases. Cervical reexploration was only required for 5 patients who had previous operations by unexperienced surgeons in other clinics. In 5 out of 7 patients operated by us, the causes of the persistent primary hyperparathyroidism were 4 adenomas and one hyperplastic gland in the mediastinum found by median sternotomy. The remaining cases were a rare ectopic location of the inferior glands and an inadequate resection in four-gland-hyperplasia. Preoperative localization procedures were carried out for most patients. 201-Tl/99m-Tc-subtraction scintigraphy has proved for localization in both the cervical region and the mediastinum to be a highly sensitive method. Reoperative parathyroid surgery can be reduced with thorough initial cervical exploration by experienced surgeons in specialized clinics.
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