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Parathyroidectomy (Parathyroid Gland Surgery)

Removal of overactive parathyroid glands to treat hyperparathyroidism and restore calcium balance

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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 (Parathyroid Gland Surgery)?

Parathyroidectomy is a focused neck surgery that removes diseased parathyroid tissue.

Most cases involve removal of a single benign adenoma; multi-gland disease (hyperplasia) requires subtotal removal of three and a half glands.

The procedure can be performed via minimally invasive (focused) approach using preoperative localization (sestamibi scan, ultrasound, 4D CT) or via traditional bilateral neck exploration.

Intraoperative parathyroid hormone (PTH) monitoring confirms cure when PTH levels drop more than 50 percent within ten minutes of gland removal.

Surgery typically lasts one to two hours and is most often performed under general anesthesia.

It is the only curative treatment for symptomatic primary hyperparathyroidism.

Symptoms

Symptoms of hyperparathyroidism that prompt surgery include kidney stones, bone pain, fragility fractures, and osteoporosis.
Fatigue, depression, cognitive fog ('moans, groans, bones, stones, and psychic overtones').
Polyuria, polydipsia, and gastrointestinal complaints such as nausea, constipation, and peptic ulcer.
Hypercalcemia confirmed by elevated serum calcium with inappropriately high PTH on blood tests.
Postoperative hypocalcemia symptoms (perioral tingling, muscle cramps) may emerge transiently.

Risk Factors

Female sex and age over 50 (peak incidence in postmenopausal women).
History of head and neck radiation in childhood.
Multiple endocrine neoplasia (MEN) types 1, 2A, and 4 syndromes.
Chronic kidney disease causing secondary or tertiary hyperparathyroidism.
Long-term lithium therapy.
Family history of hereditary hyperparathyroidism.

When to See a Doctor?

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

  • Persistent hypercalcemia (calcium above 10.5 mg/dL) with elevated PTH.
  • Recurrent calcium-containing kidney stones.
  • Osteoporosis or unexplained fragility fracture in the setting of hyperparathyroidism.
  • Symptomatic hyperparathyroidism (fatigue, bone pain, neuropsychiatric symptoms).
  • Asymptomatic patients meeting NIH guidelines: age under 50, calcium above 1 mg/dL upper limit, GFR less than 60, T-score below -2.5.

Treatment Methods

01
Preoperative localization with sestamibi-SPECT, neck ultrasound, and 4D CT to plan focused surgery.
02
Minimally invasive parathyroidectomy through a small (2-3 cm) lateral neck incision when single adenoma is identified.
03
Bilateral neck exploration if localization fails or multi-gland disease suspected.
04
Intraoperative PTH monitoring to confirm biochemical cure.
05
Subtotal (3.5 gland) parathyroidectomy or total parathyroidectomy with autotransplantation for hyperplasia.
06
Calcium and vitamin D supplementation postoperatively to manage 'hungry bone syndrome' if present.
07
Long-term follow-up with serum calcium and PTH every six to twelve months.

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.