Endocrine Abstracts

Introduction: Primary hyperthyroidism relates to the thyroid gland producing large amounts of hormone due to either uncontrolled growth of hormone-producing functional tissue. This condition needs to be treated surgically in order to prevent complications.

Objective: The aim of this study is to describe the surgical treatment of primary hyperparathyroidism.

Method: This is a retrospective study of 84 patients operated on for pimary hyperparathyroidism in our department over a period from 2015 to 2023.

Results: The mean age of our patients was 49 years, with a clear female predominance. Cervical ultrasound and parathyroid scintigraphy were performed in all cases. CT or MRI scans were performed in 5 cases. The approach was bilateral in 29% of cases, and unilateral in 71%. Among the patients operated on, a single gland was removed in 78 cases: an adenoma in 77 patients, and a hyperplasia in 1 case. Two glands were removed in 6 patients: a healthy gland with an adenoma in 2 cases, a hyperplasia of both glands in 2 patients, and a double adenoma in 2 patients. Thyroid surgery was performed in 42.8% of cases. Postoperatively, dysphonia associated with unilateral recurrent paralysis was noted in 2 cases. Early hypocalcemia was noted in 18 cases. It was related to hypoparathyroidism in 2 cases and to Hungry bone syndrome in 3. Hypocalcemia was severe, leading to generalized tetany in 3 cases. We noted normalization of PTH levels within 72 hours of surgery in 90.5% of cases. Failure was noted in 6 cases, related to incomplete surgery for triple adenoma in 1 case, hyperplasia in 3 cases, glandular ectopy in 1 case and multiple endocrine neoplasia in 1 case.

Conclusion: Surgery of primary hyperparathyroidism leads to good therapeutic results. However, there is a risk of failure. It may be related to multiple adenoma, glandular ectopy or hyperplasia of several glands.