Parathyroidectomy is surgery to remove the parathyroid glands or parathyroid tumors.
The parathyroid glands are right behind your thyroid gland in your neck. These glands help your body control the calcium level in the blood.
Your doctor may recommend this surgery if one or more of your parathyroid glands is producing too much parathyroid hormone. This condition is called hyperparathyroidism. It is often caused by a small non-cancerous (benign) tumor called an adenoma.
Your doctor will consider many factors when deciding whether to do surgery and what type of surgery would be best for you. Some of these factors are:
You will receive general anesthesia for this surgery. Usually the parathyroid glands are removed using a 2 – 4 inches surgical cut on your neck. During surgery:
Types of surgery include:
Before the Procedure
Parathyroid glands are very small. You may need to have tests that show exactly where your glands are. This will help your surgeon find your parathyroid glands during surgery. Two of the tests you may have are a CT scan and an ultrasound.
After the Procedure
People usually recover soon after this surgery. Recovery is fastest when less invasive techniques are used. Sometimes, another surgery is needed to remove more of the parathyroid glands.
The parathyroid glands are four, small, pea-shaped glands that are located in the neck on either side of the trachea and next to the thyroid gland. In most cases there are two glands on each side of the trachea, an inferior and a superior gland. Fewer than four or more than four glands may be present, and sometimes a gland / glands may be in an unusual location. The function of the parathyroid glands is to produce parathyroid hormone (PTH), a hormone that helps regulate calcium within the body.
Sometimes, benign growths called adenomas appear on one or more of a person’s parathyroid glands. The cause of most parathyroid adenomas is unknown. However, about 10 percent are thought to be hereditary. Radiation exposure of the head and neck also may increase the risk of adenomas.
Adenomas cause the parathyroid gland to make more parathyroid hormone than the body needs, a condition called primary hyperparathyroidism. Too much parathyroid hormone upsets the body’s normal calcium balance, which increases the amount of calcium in the blood stream. A similar but less common condition, called secondary hyperparathyroidism, can occur in people with chronic kidney failure.
Women are twice as likely to develop pituitary adenomas as men, and often after menopause. Primary hyperparathyroidism may be caused by one adenoma, more than one adenoma or cancer.
Parathyroidectomy is the removal of one or more of the parathyroid glands, and it is used to treat hyperparathyroidism.
Hyperparathyroidism is a condition in which the parathyroid glands produce too much PTH. If there is too much PTH, calcium is removed from the bones and goes into the blood, and there is increased absorption of calcium from the intestine into the blood. This results in increased levels of calcium in the blood and an excess of calcium in the urine. In more serious cases, the bone density will diminish and kidney stones can form. Other non-specific symptoms of hyperparathyroidism include depression, muscle weakness, and fatigue. Every effort is made to medically treat or control these conditions prior to surgery. These efforts include avoiding calcium rich foods, proper hydration and medications to avoid osteoporosis.
There are two types of hyperparathyroidism, primary and secondary. The most common disorder of the parathyroid glands and one that causes primary hyperparathyroidism, is a small, tumor called a parathyroid adenoma. A parathyroid adenoma is a benign condition in which one parathyroid gland increases in size and produces PTH in excess. In most situations patients are unaware of the adenoma, and they are found when routine blood test results show an elevated blood calcium and PTH level. Less commonly, primary hyperparathyroidism may be caused by overactivity of all of the parathyroid glands, referred to as parathyroid hyperplasia.
With secondary hyperparathyroidism, the secretion of PTH is caused by a nonparathyroid disease, usually kidney failure.
Parathyroidectomy is necessary when calcium levels are elevated, if there is a complication of hyperparathyroidism, or if a patient is relatively young. Tests such as a high-resolution ultrasound or a nuclear medicine scan help to direct the approach preoperatively or intra-operatively by identifying the location of the overactive, enlarged gland. During a parathyroidectomy, the surgeon delicately removes one or more of the tiny parathyroid glands. In some situations, both sides of the neck are explored, while in other cases a direct approach is made through a small incision. In rare situations, the offending gland cannot be found.
Whereas preoperative tests help to identify hyperparathyroidism and to direct the surgical approach, PTH levels obtained during parathyroidectiomy help to guarantee the successful resection of the abnormal gland by demonstrating a return of the PTH levels to normal after the suspected parathyroid adenoma is removed. Using this method, a PTH determination is obtained immediately prior to the resection and compared to a PTH determination done ten minutes after the resection.
The following complications have been reported in the medical literature. Anyone who is contemplating surgery must weigh the potential risks and complications against the potential benefits of the surgery or any alternative to surgery.
Patients should contact their doctor if they notice:
I came from Baghdad to India with the help of the HTW office over there. I got a good driver and the accommodation in the hospital was also good. Doctors are excellent and experienced. Ms. Tahmina (of HTW) was very helpful. The translator (Ahmed) was good. I will call the HTW office for my friends or family if they have to go to India for their operation.Mr. Hussein Ali Al-Egabi
I came to India with a diagnosis of HSIL (High-grade Squamous Intraepithelial Lesion), doctor suggested surgery after my first biopsy results showed negative. Initially, I was afraid to undergo surgery but the doctors and nurses were extremely good and their approach made me feel like home. I would like to thank Health Travellers Worldwide (HTW) for their guidance and support throughout our stay in India.Ms. Ciyizire R Clementine, Rwanda
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