2012, Number 4
Surgical experience in the management of a 1-year primary hyperparathyroidism at the Head and Neck Surgery Service of the Specialty Hospital of the National Medical Center “Siglo XXI”
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ABSTRACTObjective: To assess the usefulness of the diagnostic methods and the efficacy of parathyroidectomy and its complications.
Setting: Third level health care center (Specialty Hospital of the National Medical Center “Siglo XXI”)
Design: Retrospective, descriptive, observational, cross-sectional study.
Statistical analysis: Central tendency measures and diagnostic value tests.
Patients and method: The study included 21 consecutive adult patients subjected to surgery due to primary hyperparathyroidism (PHPT) from January 1st to December 31st 2009. Analyzed variables were: age, gender, familial antecedents of parathyroid pathology, clinical manifestations, pre-operative and post-operative serum levels of calcium, phosphorus, and parathyroid hormone levels, creatinine depuration, bone densitometry; diagnostic value of preoperative location study and histopathological report.
Results: Ninety percent of patients were women with a mean age of 57 years. Nephrolithiasis, systemic arterial hypertension, and fatigue were the clinical manifestations most frequently associated with primary hyperparathyroidism. Ultrasonography and scintigraphy showed low sensitivity, low positive predictive value, moderate specificity, and moderate negative predictive value. Surgical approach was unilateral in 10 patients (47.5%), bilateral in 52.5%; therapeutic efficacy was of 85.7% for the first intervention, and of 100% for re-intervention. Complications were encountered in 4.7% of patients.
Conclusion: In this series, patients with primary hyperparathyroidism presented nephrolithiasis more frequently, sensitivity of ultrasonography and scintigraphy in relation to specific location of glands was lower than reported. High surgical efficacy of the parathyroidectomy was achieved with low frequency of complications.
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