TY  - JOUR
T1  - STrategy in reoperative surgery for hyperparathyroidism
AU  - Cheung PY, Borgstrom A, Thompson NW
Y1  - 1989/06/01
N1  - 10.1001/archsurg.1989.01410060038008
JO  - Archives of Surgery
SP  - 676
EP  - 680
VL  - 124
IS  - 6
N2  - • Eighty-three patients undergoing reoperations for hyperparathyroidism were studied. Preoperative diagnosis was reviewed, and localization was employed in selected patients. Cervical reexploration was carried out in a systematic manner, and mediastinotomy was required in 11 patients. Sixty patients had had previous parathyroid exploration. Missed adenomas were found in 34, of which 28 were single and 6 were double adenomas. Fourteen single adenomas were in normal locations and 14 were in ectopic locations. Seventeen patients had hyperplasia; 6 were wrongly diagnosed as adenoma, 3 had inadequate excision, 2 had supernumerary glands, and 6 had remnant hypertrophy. Three patients had recurrent carcinoma. Two had wrong diagnoses and 4 had uncertain diagnoses. Reoperation eliminated hypercalcemia in 71 patients (85.5%). Eight patients developed permanent hypoparathyroidism, and 1 had a permanent recurrent nerve palsy. Reoperative parathyroid surgery can be minimized with thorough initial cervical exploration, correct pathologic interpretation, and adequate parathyroid resection.(Arch Surg. 1989;124:676-680)
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.1989.01410060038008
UR  - http://dx.doi.org/10.1001/archsurg.1989.01410060038008
ER  -