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Discussion

    Published:October 22, 2015DOI:https://doi.org/10.1016/j.surg.2015.08.041
        Dr Christopher R. McHenry (Cleveland, OH): You defined tertiary hyperparathyroidism as a PTH of >72. As you know, most of these patients can have very, very marked elevation in their PTH levels. I wondered, of your total patients with tertiary hyperparathyroidism, do you have any information, then, on what percentage of these patients resolved with additional time beyond your 9-month period? You said that only 6% or such actually were operated on, but of those patients that were not operated on, was there a subset of patients that went on to eventually resolve their tertiary hyperparathyroidism? My second question is, in your abstract, you talked about a 12% long-term recurrence rate. I wondered, what was the cause for the recurrence? Was this remnant hyperplasia? Was this owing to supernumerary glands? How did you deal with these patients that had recurrence?
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