• Recent reports in the literature have indicated an alarming increase in the incidence of recurrence following operation for hyperparathyroidism. Factors contributing to recurrent disease in 20 patients seen at the University of California at Los Angeles (UCLA) Medical Center included unrecognized multiple gland involvement in 12 patients, aberrant location of glands in nine, misleading pathologic information in eight, and supernumerary glands in two. The results of special diagnostic studies such as thermography, selective venous catheterization for parathyroid hormone assay, and selective arteriography have been reviewed. Some recommendations include histologic identification of all parathyroid glands, a systematic search of the most probable locations for aberrant glands, and subtotal parathyroidectomy at the time of the initial operation in patients at increased risk for recurrence.
(Arch Surg 111:688-691, 1976)