Parathyroidectomy

Parathyroidectomy
Intervention
Parathyroidectomy for parathyroid adenoma
ICD-9-CM	06.8
MeSH	D016105

Also known as "Parathyroid gland removal", Parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone. As drugs such as Fosamax do not treat the underlying cause of parathyroid-related osteoporosis, surgery is the only cure. Bone loss is reversible.

The location of the glands is generally behind the thyroid, but there is a lot of variation. Usually, the location of an enlarged gland has been confirmed via a sestamibi scan or on ultrasound.

Procedure

During the operation, the patient is usually put under a general anesthetic (unconscious and pain free) or a local anesthetic (pain free). The surgeon makes an incision around an inch long in the neck just under the Adam's apple and locates the offending parathyroid glands. Preoperative testing using sestamibi scanning can help identify the location of glands. It can also be used to limit the extent of surgical exploration when used in conjunction with intraoperative PTH hormone monitoring.^[1] The particular problem or disease process will determine how many of the parathyroid glands are removed. Some parathyroid tissue must be left in place to help prevent hypoparathyroidism.

The patient usually recovers very quickly after the operation. The PTH level is back to normal within 10–15 minutes, and is confirmed by intraoperative rapid assessment during the operation. However, the remaining parathyroid glands may take hours to several weeks to return to their normal functioning levels. Patients must be placed on calcium supplements to prevent symptoms of hypocalcemia and to restore lost bone mass.

References

1. ↑ Augustine, MM; Bravo, PE, Zeiger, MA (2011 Mar-Apr). "Surgical treatment of primary hyperparathyroidism.". Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 17 Suppl 1: 75–82. doi:10.4158/EP10359.RA. PMID 21324817.  Cite uses deprecated parameters (help); Check date values in: |date= (help)

• Lee, J.A. (2006-10-16). "Parathyroidectomy". Medical Encyclopedia. Medline Plus. Retrieved 2007-11-02. 

• Nanka O, Sedý J, Vítková I, Libánský P, Adámek S (2006). "Surgical anatomy of parathyroid glands with emphasis on parathyroidectomy". Prague Med Rep 107 (2): 261–72. PMID 17066745. 

External links

• Information from the American Association of Endocrine Surgeons