Resumo

FUENTES, MM.; VARAS DE, DB; SANCHEZ, AR.  e  PORRERO, C.. Experiencia en el tratamiento quirúrgico del hiperparatiroidismo primario. Rev. argent. endocrinol. metab. [online]. 2019, vol.56, n.3, pp.31-40. ISSN 1851-3034.

Introduction

A retrospective study was conducted on 60 patients operated of primary hyperparathyroidism from January 2005 to January 2017. We collected clinical data, biochemical parameters and the surgery characteristics included the measurement of intraoperative parathormone (IOPPTH).

Results

Sixty operated patients aged 55, 5 ± 15, 3 years (85 % female) were studied. The main surgical criteria was the hypercalcemia, but 15% of the patients had normocalcemic hyperparathyroidism. Adenoma was the most frequent diagnosis.

Most patients had preoperative imaging studies with parathyroid disease. In patients with more than one imaging studies the agreement in the localization of abnormal parathyroid gland was 66%.

IOPPTH dropped >50% in the 85,7% of the patients. The IOPPTH mean decrease was 67,6% and 27,8% in the patients who achieved healing or not and the median last IOPPTH in surgery was 48,1 pg/ml (13,7-76,3) vs 114 pg/ml (15-226).

Patients who achieved healing after surgery were significantly younger. They had ten minutes IOPPTH and postoperative calcium lower and adenoma was the most common diagnosis.

Conclusions

Primary hyperparathyroidism occurs in clinical practice with an increasingly broad spectrum. The selection of patients candidates for surgery must be carried out accurately, in order to obtain the greatest possible clinical benefit. The measurement of IOPPTH is a useful tool in the surgical treatment and it provides a prognostic value in the follow-up of these patients.

Palavras-chave : Primary hyperparathyroidism.

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