Predictors of Outcomes of Parathyroidectomy for Primary Hyperparathyroidism: A Retrospective Observational Study. | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 18, Issue 3, July 2025, Page 260-269 PDF (434.1 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asjs.2025.392311.1208 | ||||
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| Authors | ||||
| Waseem Abdelaziz Elsayed* 1; Mohamed Kamel Safina2; Emad Eldein Mustafa Abdel Hafez3; Ghada Mohamed Saied4; Nagm Eldin Abu Elnga Ahmed2 | ||||
| 1Department of General and Oncology Surgery, Faculty of Medicine, New Valley University | ||||
| 2Department of General and Oncology Surgery, Faculty of Medicine, Assiut University | ||||
| 3Department of General and Oncology Surgery, Faculty of Medicine, Benha University | ||||
| 4Department of Clinicl Pathology, Faculty of Medicine, New Valley University | ||||
| Abstract | ||||
| Introduction: Parathyroidectomy (PTX) is highly effective in treating PHPT. It leads to decreased serum PTH and equalizes calcium/phosphate homeostasis, reduces inflammatory-cardiovascular risk, and improves diastolic and systolic functions within the first-month post-surgery. Moreover, PTX significantly decreased the prevalence of anemia in PHPT patients six months after surgery. Furthermore, PHPT worsens sleeping patterns, but PTX improved the patient’s mood and sleep patterns with more deep sleep and fewer nighttime awakenings. Aim of work: This retrospective study aimed to define the surgical and biochemical outcomes of parathyroidectomy for patients with primary hyperparathyroidism (PHPT) and to identify potential predictors for these outcomes. Patients and methods: Twenty-nine files of patients who underwent parathyroidectomy for PHPT were analyzed. Preoperative demographic, clinical, radiologic, and biochemical data were collected. Intraoperative (IO) and postoperative (PO) data were gathered. The percentage of PO changes in serum parathormone (PTH) and calcium and the frequency of PO normalization of PTH were evaluated. Results: Six files (20.8%) indicated normocalcemia, while 23 showed hypercalcemia. Nine patients had recurrent urolithiasis with significantly higher frequency among normocalcemic patients. Postoperative serum PTH levels decreased significantly, and all patients became normocalcemic. PO serum PTH and calcium levels were reduced by ≥50% in 72.4% and by ≥25% in 62.1% of samples, respectively with significant differences in favor of hypercalcemics. Patients were managed as one-day cases after assurance of competence in hemodynamic and respiratory functions. PO complications were identified in 5 files (17.2%) and superficial wound infection is the commonest. The correlation analysis detected a positive significant relationship between preoperative parathyroid volume and preoperative serum PTH and calcium levels, normocalcemia, PO percentage of change in serum PTH and calcium, and the normalization of serum PTH. Conclusion: This retrospective data analysis confirmed the safety and effectiveness of parathyroidectomy for PHPT patients and supports its feasibility as a one-day procedure. Preoperative assessment of gland volume is crucial for surgical planning and aids in predicting PO biochemical outcomes. Preoperative normocalcemia did not influence surgical outcomes, despite being associated with a higher incidence of urolithiasis. | ||||
| Keywords | ||||
| Primary hyperparathyroidism; parathyroidectomy; parathyroid gland volume; parathormone | ||||
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