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Background. Diagnosis of primary hyperparathyroidism (PHPT) is increasingly suspected in elderly
patients after the discovery of hypercalcemia by routine measurement of serum calcium
levels. Surgery is commonly accepted as the optimal treatment of PHPT. We wanted to
assess risk and results of neck exploration in elderly patients with PHPT.
Methods. We performed a retrospective study of the charts of 78 patients older than 75 years
(mean age, 79.1 years) with PHPT who underwent neck exploration during a 15-year period.
Results. The most common presenting symptoms were neurologic and psychiatric disorders (47
patients). Preoperative localization investigations, performed in 72 patients, were
successful in 42 of them (sensivity, 58%). Single adenoma, double adenomas, and hyperplasia
were found in 74 patients (95%), three patients, and one patient, respectively. Overall
postoperative mortality was 3.8% (three patients) with no death since 1984. Significant
complications occurred in three patients (4%): one myocardial infarction, one pulmonary
embolism, and one cerebral hemorrhage. Average length of postoperative hospital stay
was 4 days. Among patients who could be followed up (65 cases with a mean follow-up
of 3 years), 94% reported an improvement in their symptoms. This was especially marked
for fatigue and intellectual function.
Conclusions. These data support a liberal approach regarding surgical treatment in elderly patients
with PHPT.
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Article info
Publication history
Accepted:
September 2,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
