TREATMENT OUTCOME OF PRIMARY HYPERPARATHYROIDISM AFTER BILATERAL NECK EXPLORATION

Objective: To evaluate the results of bilateral neck exploration in patients with primary hyperparathyroidism (PHPT). Study design: A semi-experimental study. Configuration and duration: Between May 2016 to May 2017, Surgery Department Unit II of Lahore General Hospital. Methodology: In this study, 37 patients with PHPT who underwent parathyroidectomy with bilateral neck pain were included in the study. Parathyroidectomy was performed in 37 patients with bilateral neck examination by a single surgeon. Preoperative localization was performed in all patients with neck ultrasound and sestamibi and in intraoperative localization with methylene blue. The results were evaluated with postoperative serum parathormone (PTH) levels, serum calcium levels and recurrence symptoms. Results: Of the 37 patients, 28 had only one adenoma on the right, 18 on the right and 10 on the right. In 8 patients, 6 patients had more than one adenoma on the same side and 2 patients on the same side were at the same time 1 hour 30 minutes. Postoperative hypocalcemia was observed in 5 patients with serum calcium ranging from 5.5 to 7 mg / dl and improved by supplementation with oral calcium and vitamin D, and two patients developed seroma which improved with aspiration. There was no incidence of recurrent laryngeal nerve injury. Conclusion: Our limited study has shown that bilateral neck exploration for PHPT is an ideal approach with regard to latent adenoma and subsequent re-exploration risk. Key words: primary hyperparathyroidism (PHPT), parathyroidectomy, adenoma