Long-term results of parathyroidectomy for hypercalcemic crisis

John Lew, Carmen C. Solorzano, George L. Irvin

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Hypothesis: Hypercalcemic crisis is a rare complication of severe calcium intoxication usually caused by sporadic primary hyperparathyroidism that requires prompt diagnosis and definitive surgical treatment. Parathyroidectomy is essential for long-term successful treatment of hypercalcemic crisis. Design: Retrospective case series. Setting: Tertiary referral center. Patients: Forty-three patients treated for hypercalcemic crisis during a 35-year period who had signs and symptoms of acute calcium intoxication and serum calcium levels of 15 mg/dL (3.75 mmol/L) or greater. Main Outcome Measures: Operative success, operative failure, and disease recurrence after surgery. Kaplan-Meier analysis was used to estimate long-term survival after parathyroidectomy. Results: Forty-two (98%) of 43 patients were eucalcemic after initial parathyroidectomy. There was 1 postoperative death. Of 27 patients with postoperative calcium data available for 6 months or longer, operative success was achieved in 26 (96%). There was 1 operative failure in a patient with multiglandular disease requiring reoperation. There were 3 recurrences (7%) at 7, 58, and 265 months. Overall median survival after parathyroidectomy was 11.7 years (95% confidence interval, 9.2-NE [not estimable]). The mean±SD serum calcium level of this group at a median follow-up of 4 years after surgery was 9.1±0.9 mg/dL (2.28±0.23 mmol/L). Conclusion: Hypercalcemic crisis can be successfully treated by parathyroidectomy with continued normal parathyroid function and excellent long-term survival.

Original languageEnglish
Pages (from-to)696-699
Number of pages4
JournalArchives of Surgery
Volume141
Issue number7
DOIs
StatePublished - Jul 24 2006

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Parathyroidectomy
Calcium
Survival
Recurrence
Primary Hyperparathyroidism
Kaplan-Meier Estimate
Serum
Reoperation
Tertiary Care Centers
Signs and Symptoms
Outcome Assessment (Health Care)
Confidence Intervals
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Long-term results of parathyroidectomy for hypercalcemic crisis. / Lew, John; Solorzano, Carmen C.; Irvin, George L.

In: Archives of Surgery, Vol. 141, No. 7, 24.07.2006, p. 696-699.

Research output: Contribution to journalArticle

Lew, John ; Solorzano, Carmen C. ; Irvin, George L. / Long-term results of parathyroidectomy for hypercalcemic crisis. In: Archives of Surgery. 2006 ; Vol. 141, No. 7. pp. 696-699.
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