Abstract

This study was conducted to elucidate epidemiological patterns of patients who presented to our institution and assess indications, role of preoperative localization, analyse intraoperative details and postoperative recovery and recurrence patterns of those who underwent parathyroidectomy. Material and Methods: Data of patients diagnosed with primary hyperparathyroidism from December 2014 to December 2021 were retrieved from medical records. Demographics, preoperative investigations, operative details and follow up were studied. Results: Out of 37 patients identified, 29 underwent bilateral neck exploration by collar crease incision and 8 underwent Video assisted Parathyroidectomy. All of our patients were hailing from in and around southern India, with a median age of presentation at 41.38 ± 14 which was congruent with national average as per PHPT registry. Interestingly the gender distribution was at 0.9:1 - female to male ratio, which was drastically different from the national values of 2.4:1. The median duration of surgery averaged 120 minutes for minimally invasive procedures against a global average of 78 minutes, similarly bilateral neck explorations averaged at 180 minutes against 150 minutes, highlighting the need of high-volume centers, while the costs were substantially lower ranging from $285-$1821 against global expenditures of $ 2693-$ 4112. All but one patient had sestamibi scans done for preoperative localization, in almost all cases ultrasounds were done which yielded information on par with sestamibi. Conclusion: Though being a low volume center, surgeon dependent intraoperative localization of parathyroid adenoma without use of any adjuncts was adequate, highlighted by negligible persistence and recurrence rate.

Description

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