Primary hyperparathyroidism. Relationship between surgical technique and postoperative calcium levels in patients with single parathyroid adenomas.

The relationship between extent of surgery and calcium levels 6-12 months postoperatively has been analysed in 177 patients in whom a parathyroid adenoma was found at exploratory surgery of the neck. The analysis showed that the frequency of postoperative hypocalcaemia and the need of longterm calcium and vitamin D supplements increased if macroscopically normal glands were extirpated and/or biopsied in addition to removal of the adenoma. It was also shown that the frequency of postoperative hypercalcaemia was similar in patients in whom the peroperative histopathological examination of macroscopically normal glands showed normal cellularity or hyperplasia. The data favour a more conservative approach in parathyroid surgery.