PRIMARY HYPERPARATHYROIDISM

In the period from 1. 1. 1986 to 31. 12.1991 129 patients underwent surgery because of pHPT in the department of surgery of the University Munster. Based on the patients data we examined retrospectively the symptoms of the patients, comorbidities and the preoperative performed diagnostic procedures. Especially we investigated the surgical therapy. The symptoms of pHPT are not clear in every case. In increasing cases the disease will be diagnosed occasionally by screening methods (13,2%). In our patients we found mainly renal manifestation. Renal stones were found in the history of 45,7% of the patients. In case of recurrent renal stones pHPT should be excluded. Elevated plasma calcium levels and elevated parathormone are leading findings for the diagnosis. The indication for surgery is given with the diagnosis also in asymptomatic patients. Before primary surgery invasive investigations of the adenomas location is unnecessary. In every case we perform ultrasound. This procedure was positive for the localisation of adenoma in 82,4%. Also in the case of identical preoperative and intraoperative findings all four parathyroid glands should be identified because more adenomas will be found in 20% of all cases.