Abstract
Background. To assess the impact of surgery on preoperative symptoms in secondary (2°) and tertiary
(3°) hyperparathyroidism (HPT) compared with primary (1°) HPT. Methods. Twenty-two patients with 2° HPT and 10 with 3° HPT were enrolled. Age-matched patients,
32 with 1° HPT and 32 with thyroid disease were enrolled for comparison. An outcome
questionnaire documented symptoms expressed as the median symptom index score (MSIS)
preoperatively and at days 7 and 3 and 12 months postoperatively. Results. Preoperatively, the MSIS for the groups with 3°, 2°, and 1° HPT and thyroid disease
was 225, 572, 372, and 146, indicating that patients with HPT were more symptomatic
than those in the thyroid group (P <.05). Patients with 1° HPT had a decrease in their MSIS at day 7 (195, P <.05) and at 3 and 12 months (159 and 156). Patients with 3° HPT also had a decrease
in their MSIS over time. Patients with 2° HPT had a decrease in their MSIS at day
7 (469, P <.05); however, they remained more symptomatic at 3 and 12 months (410 and 355).
Conclusions. Parathyroidectomy reduces many of the preoperative symptoms in HPT. Patients with
1° and 3° HPT have a similar resolution of their symptoms. Patients with 2° HPT have
an improvement in many of their symptoms, although they remain more symptomatic at
1 year. (Surgery 2000;128:531-9.)
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Indications for parathyroidectomy and extent of treatment for patients with secondary hyperparathyroidism.Surg Clin North Am. 1995; 75: 465-482
- A case control study of proximal calciphylaxis.Am J Kidney Dis. 1998; 32: 376-383
- A study on pruritus after parathyroidectomy for secondary hyperparathyroidism.J Am Coll Surg. 2000; 190: 65-70
- Results of surgical treatment for hyperparathyroidism associated with renal disease.Am J Surg. 1990; 160: 337-340
- Subtotal parathyroidectomy verus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial.World J Surg. 1991; 15: 745-750
- Long-term results of total parathyroidectomy without autotransplantation in patients with and without renal failure.Miner Electrolyte Metab. 1999; 25: 161-170
- Prospective surgical outcome study of relief of symptoms following surgery in patients with primary hyperparathyroidism.World J Surg. 1998; 22: 513-519
- A retrospective analysis on the change in symptoms resulting from hyperparathyroidism following surgical intervention; allowing for the validation of a prospective surgical outcome study questionnaire (abstract).World Congress of Surgery. 1995; 338: 83
- Measuring disease specific quality of life in clinical trials.Can Med Assoc J. 1986; 134: 889-895
- Measurement of health status.Med Care. 1985; 23: 696-704
- Response to parathyroidectomy at the axial and appendicular skeleton in renal patients.Clin Nephrol. 1999; 52: 172-178
- Disappearance of uremic itching after subtotal parathyroidectomy.N Engl J Med. 1968; 296: 1575-1580
- Muscular performance and fatigue in primary hyperparathyroidism.World J Surg. 2000; 24: 102-107
- General weakness as an indication for parathyroid surgery in patients with secondary hyperparathyroidism.Arch Surg. 1999; 134: 1108-1111
- Muscle strength and endurance after surgery for primary hyperparathyroidism.Eur J Surg. 1998; 164: 489-494
- Therapeutic controversies in primary hyperparathyroidism.J Clin Endocrinol Metab. 1999; 84: 2275-2285
- Surgical correction of primary hyperparathyroidism improves quality of life.Surgery. 1998; 124: 987-992
- Psychiatric symptoms, bone density and non-specific symptoms in patients with mild hypercalcemia due to primary hyperparathyroidism; a systematic overview of the literature.Endocr J. 1997; 44: 367-374
Article info
Footnotes
*Reprint requests: Dr Janice L. Pasieka, Clinical Professor and Chief, Division of General Surgery, Foothills Medical Center, 1403 29th St NW, Calgary, Alberta, Canada, T2N 2T9.
**Surgery 2000;128:531-9
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
