Reoperative parathyroid surgery for persistent hyperparathyroidism.


In a 2-year period 30 patients with persistent hyperparathyroidism following 59 prior unsuccessful procedures underwent reoperation. Preoperative arteriography was useful in planning the surgical approach in 56%, and retrospectively was correct in 63%. Selective venous catheterization gave localizing information in 83%, correctly predicting site or side in 60% of the total. Computerized axial tomography was helpful in identifying mediastinal glands before operation. Reoperation was successful in rendering the patient hypocalcemic or normocalcemic in 83%. Of the 11 patients (37%) who were rendered profoundly hypocalcemic, two were subsequently weaned from vitamin D and calcium support; seven have received either fresh or cryopreserved parathyroid autografts. Persistent hyperparathyroidism is a difficult surgical problem which we believe warrants aggressive localization attempts prior to operation. Autotransplantation with cryopreserved parathyroid tissue may be of value in the long-term management of the high incidence of postoperative hypocalcemia in this patient group.


Citations per Year

3,459 Citations

Semantic Scholar estimates that this publication has 3,459 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Brennan1978ReoperativePS, title={Reoperative parathyroid surgery for persistent hyperparathyroidism.}, author={Murray F. Brennan and John L. Doppman and Stephen J . Marx and Alien M. Spiegel and Edward Brown and Gerald D. Aurbach}, journal={Surgery}, year={1978}, volume={83 6}, pages={669-76} }