What is the role of parathyroidectomy in the treatment of primary hyperparathyroidism?

Updated: Oct 02, 2018
  • Author: Lawrence Kim, MD, FACS, FACE; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Answer

For familial disease, such as MEN 1, total parathyroidectomy is performed with autotransplantation to the forearm and cryopreservation of some parathyroid tissue. [27]

Parathyroidectomy is usually well tolerated. The main risks are injury to the recurrent laryngeal nerves and hypoparathyroidism due to resection or devascularization of all parathyroid glands. Although local anesthesia has been used successfully for this procedure, especially in the directed approaches during which a single adenoma is localized preoperatively, general anesthesia is used most commonly. In patients in whom hypercalcemia (and, therefore, dehydration) has been severe, special attention must be directed to perioperatively restoring the fluid balance. Neck mobility must be assessed to ensure proper positioning in the operating room.


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