PARATHYROIDECTOMY IN PATIENTS WITH HYPERPARATHYROIDISM

Abstract

Aim: The aim of this study was to analyze all the factors (disease symptoms, sinthigraphic findings, biochemical parameters) that occur in patients with hyperparathyroidism, and since hyperparathyroidism itself is a common endocrine disorder. Methods: We analyzed 79 patients with primary, secondary, and tertiary hyperparathyroidism, who underwent surgery. We analyzed mean of age, male: female ratio, representation of different forms of hyperparathyroidism. In our study, we examined the indications for examination and surgery, as well as the most common symptoms and comorbidities. For localization PTG, scintigraphy was performed by a nuclear medicine specialist (at the Clinic of Radiology and Nuclear Medicine) preoperatively. Preoperative values of calcium (Ca), phosphorus (P), and parathyroid hormone (PTH) were determined in all patients, and the same values were measured postoperatively. We also analyzed correlation of dialysis length and parathyroid gland hyperplasia in patients with secondary hyperparathyroidism. Results: In our study mean of years was 51.13 ± 11.83 and most of the respondents were female. The most common operation was subtotal parathyroidectomy. The most common indication for examination of parathyroid glands (PTG) was renal failure. The most common comorbidity was arterial hypertension, which was found in 43 (53.2%) subjects, and the rarest gastrointestinal diseases and pancreatitis, in 1 (1.3%) patients. Scintigraphy showed an equal representation of enlarged lower parathyroid glands (both right and left). The mean values determined preoperatively for PTH were 796.24 pg/ml, Ca 2.58 mmol / l and P 1.35 mmol / l. The mean postoperative values for PTH were 222.33 pg/ml, Ca 2.06 mmol/l and P 1.17 mmol/l. We also showed that was a large correlation between dialysis length and hyperplasia. Conclusion: Hyperparathyroidism is a common endocrine disease, carrying potential complications of many organic systems. In most cases, regardless of the form (primary, secondary, or tertiary), it ultimately requires surgical treatment. For this reason, the clinical picture must be well known, the necessary preoperative diagnostic methods (which are complex), all with the aim of better effect of treatment of such patients.