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World J Clin Cases. Apr 6, 2023; 11(10): 2213-2225
Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2213
Update on the current management of persistent and recurrent primary hyperparathyroidism after parathyroidectomy
Efstathios T Pavlidis, Theodoros E Pavlidis
Efstathios T Pavlidis, Theodoros E Pavlidis, The Second Propedeutic Department of Surgery, Hippocration Hospital, School of Medicine, Aristotle University, Thessaloniki 54642, Greece
Author contributions: Pavlidis TE designed research, contributed new analytic tools, analyzed data and review; Pavlidis ET performed research, analyzed data review and wrote the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Theodoros E Pavlidis, PhD, Full Professor, Surgeon, The Second Propedeutic Department of Surgery, Hippocration Hospital, School of Medicine, Aristotle University, Konstantinoupoleos 49, Thessaloniki 54642, Greece. pavlidth@auth.gr
Received: January 18, 2023
Peer-review started: January 18, 2023
First decision: January 31, 2023
Revised: February 1, 2023
Accepted: March 15, 2023
Article in press: March 15, 2023
Published online: April 6, 2023
Core Tip

Core Tip: Surgical intervention can permanently cure primary hyperparathyroidism. Advances in preoperative imaging and localization as well as intraoperative parathormone monitoring have significantly reduced the rates of persistence and recurrence. The criteria for reoperation must be stricter and based on biochemical confirmation of the diagnosis, review of preexisting data, and positive imaging findings. However, diagnosis and treatment are multidisciplinary tasks. The final decision about reoperation and its procedure should be made by an experienced endocrine surgeon. In any case, preoperative assessment of recurrent laryngeal nerve function and intraoperative measurement of parathyroid hormone are necessary.