Durability of focused minimally invasive parathyroidectomy in young patients with sporadic primary hyperparathyroidism

Ann Surg Oncol. 2011 May;18(5):1290-2. doi: 10.1245/s10434-010-1417-1. Epub 2010 Nov 25.


Background: Historically, multigland hyperplasia was believed to be the predominant cause of primary hyperparathyroidism (PHPT) in young patients, and hence a relative contraindication for minimally invasive parathyroidectomy. Recent studies, however, demonstrate that the most common aetiology across all age groups is a solitary functioning adenoma. The aim of this study was to compare long-term outcomes in young patients (≤ 45 years), especially those under 30 years of age, with their older counterparts (> 45 years) following focused minimally invasive parathyroidectomy (FMIP).

Materials and methods: Patients ≤ 45 years who underwent FMIP between January 1999 and December 2007 were identified from an endocrine surgery database and compared with a matched control group of patients > 45 years old also undergoing FMIP within that time period. The patients' most recent calcium levels (≥ 6 months postoperatively) were examined to establish recurrence rates. Recurrence was defined as an elevation of serum calcium more than 6 months after surgery following initial postsurgical normocalcemia.

Results: A total of 117 patients ≤ 45 years and 160 patients > 45 years who underwent FMIP were examined. Follow-up calcium levels were available for 72% of patients. The median length of follow-up was 46 months. No recurrences were identified in both the younger and older cohort of patients; therefore, no statistically significant difference in rates of recurrence could be determined between age groups.

Conclusion: Recurrence of PHPT following FMIP is rare with no evidence of a higher incidence in younger patients. FMIP can be safely offered to young patients as a long-term durable treatment option.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Calcium / blood
  • Case-Control Studies
  • Female
  • Humans
  • Hyperparathyroidism, Primary / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Parathyroidectomy*
  • Prognosis
  • Recurrence


  • Calcium