Endocrine Abstracts

Retrospective audit of Patients had Parathyroidectomy over 2 years in East Sussex NHS trust; 73 patients had Parathyroid surgery for Primary hyperparathyroidism during this period. We have collected the data using case notes and hospital electronic records. Fifty-six patients were females and 17 were Males. Ninety-three per cent of patients were more than 50 years old. Common presenting symptoms were Lethargy (51%), bone pain (44%) and other symptoms were polyuria, polydipsia. Incidental finding in 15%. All patients had corrected calcium, parathyroid hormone levels and renal functions measured. Only 92% had tests for 24 h. urine calcium and Vitamin D levels. Cacl;crcl or fractional excretion were documented in only 12% of cases. Pre-operative localization of parathyroid adenoma was successful with ultrasound scan in 84%, SestaMIBI scan 94% and with SPECT CT 22%. All patients had both ultrasound parathyroid and sestaMIBI scan and only 75% has SPECT CT scan. Only 44% of patient had documented evidence of DEXA scan. Eighteen per cent of patients had evidence of osteoporosis. Ninety per cent of patients had preoperative localization of adenoma. Sixty-two per cent of patients had indications of permanent treatment. Successful removal of parathyroid adenoma was achieved in 95% of patients with normalization of post-operative calcium. Positive Correlation between preoperative scans results and surgical finding were seen in 88% of patients. Six patients were persistently hypercalcemic post operatively. Three patients (4%) had evidence of vocal card paralysis. Ninety-five per cent of patients had follow up appointment once within 6 months after the surgery. Most patient had 24 h urine calcium measurement, but there is no documentation about cacl;crcl or fractional excretion of calcium measurements in the notes to exclude Familial hypocalciuric hypercalcemia. Thirty-eight per cent of patients not had international consensus guidelines criteria for permanent treatment. We have started Parathyroid multidisciplinary meeting to discuss patients before surgical treatment since.