The role of transcervical thymectomy in patients with hyperparathyroidism.

The role of transcervical thymectomy in patients with hyperparathyroidism.

Welch Kellen; McHenry Christopher R

American journal of surgery

2012

2012-03

BACKGROUND: The most common location for supernumerary or ectopic parathyroid glands is the thymus. METHODS: A review of patients who underwent parathyroidectomy for hyperparathyroidism from 1990 to 2010 was completed to determine indications for thymectomy, the yield of parathyroid tissue, and outcome of therapy. RESULTS: Seventy of 379 patients with hyperparathyroidism underwent parathyroidectomy and transcervical thymectomy. Intrathymic parathyroid tissue was present in 23 (33%) patients, including supernumerary glands in 8 patients (11%). Indications for thymectomy were renal hyperparathyroidism in 35 patients (50%) and primary hyperparathyroidism with a missing inferior gland in 20 patients (29%), an ectopic adenoma in 9 patients (13%), hyperplasia in 5 patients (7%), and carcinoma in 1 patient (1%). Cure rates were similar (96% and 98%; P = not significant) and only transient hypocalcemia was higher (51% vs 24%, P \textless .05) after parathyroidectomy with thymectomy versus parathyroidectomy alone. CONCLUSIONS: Transcervical thymectomy results in a high yield of parathyroid tissue and is essential for cure of selected patients with hyperparathyroidism.

*Thymectomy/methods; Adult; Aged; Female; Humans; Hyperparathyroidism/etiology/pathology/*surgery; Hypocalcemia/etiology; Male; Middle Aged; Parathyroidectomy; Postoperative Complications; Retrospective Studies; Thymus Gland/pathology/surgery; Treatment Outcome

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292–5; discussion 295–296

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