Complications to subtotal parathyroidectomy.

Seventy-three patients were operated on for confirmed hyperparathyroidism. Identification of all glands was done by 1/3 biopsies for histopathologic examination on frozen section during the operation. In cases of adenoma only, the adenoma was removed except for the biopsies. In cases of hyperplasia, subtotal resection was made, leaving between a half-gland and a whole gland. The frequency of complications was analysed. Temporary hypocalcemia occurred in a similar frequency in both adenoma and hyperplasia groups. Permanent hypocalcemia was present in only one patient. At follow-up 3-5 years after operation, 98.6% of the patients were normocalcemic. Ionized and total serum calcium were normalized 3 months after operation and remained so for the rest of the follow-up period. Serum phosphate, serum magnesium and serum parathormone also remained normal. Thus identification of parathyroid glands with biopsies or subtotal parathyroidectomy in cases with hyperplasia did not increase the risk of postoperative complications.