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Parathyroidectomy

Surgical removal of hyperfunctioning parathyroid gland(s) for primary or tertiary hyperparathyroidism.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Parathyroidectomy?

Parathyroidectomy removes one or more hyperfunctioning parathyroid glands (adenoma, hyperplasia, or carcinoma) to restore normal calcium homeostasis.

Indications in primary hyperparathyroidism include symptomatic disease (kidney stones, osteoporosis, fractures), asymptomatic disease meeting AAES/ATA 2016 criteria, or age <50 years.

Minimally invasive parathyroidectomy is performed when sestamibi scan, 4D-CT, or ultrasound localizes a single adenoma; intraoperative PTH monitoring confirms cure.

Bilateral neck exploration is indicated for negative/discordant localization, multigland disease, MEN syndromes, or secondary/tertiary hyperparathyroidism.

Symptoms

Presentations indicating surgery:
Kidney stones (calcium oxalate/phosphate)
Osteoporosis, fragility fractures, bone pain
Hypercalcemia symptoms — fatigue, weakness, cognitive changes
Nephrocalcinosis or decreased renal function
Severe hypercalcemia (>12 mg/dL) or hypercalcemic crisis

Risk Factors

Recurrent laryngeal nerve injury (<1% in experienced hands)
Persistent or recurrent disease (5% after first surgery)
Multigland disease or MEN syndromes
Ectopic parathyroid glands (mediastinal, intrathyroidal)
Hungry bone syndrome after parathyroidectomy
Prior neck surgery (reoperative technical difficulty)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Elevated calcium with elevated or inappropriately normal PTH
  • Kidney stones or osteoporosis with hypercalcemia
  • Tertiary hyperparathyroidism after renal transplantation

Treatment Methods

01
Minimally invasive targeted parathyroidectomy with intraoperative PTH monitoring
02
Bilateral four-gland exploration for multigland disease or MEN
03
Subtotal parathyroidectomy (3.5 glands) with autotransplantation for MEN-1
04
Total parathyroidectomy with forearm autotransplantation for secondary/tertiary HPT
05
Intraoperative frozen section when parathyroid carcinoma is suspected
06
Postoperative calcium/vitamin D supplementation and monitoring for hungry bone syndrome

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.