Parathyroidectomy

1 What is a Parathyroidectomy?

Parathyroidectomy is medical surgery during which one or more of the parathyroid glands are removed. It is used to treat hyperparathyroidism.

The parathyroid glands are four, small glands in the shape of a pea. They are located in the neck on either side of the main airway called trachea in pairs and next to the thyroid gland.

Their function is to produce a hormone called parathyroid hormone (PTH) which helps regulate calcium within the body. If parathyroid glands produce too much PTH, calcium is removed from the bones into the blood so the bone density can be diminished and kidney stones can form.

This condition is called hyperparathyroidism and there are two types, primary when the increase secretion of PTH is caused a small tumor called a parathyroid adenoma and secondary when it is caused by a nonparathyroid disease, usually kidney failure.

Before surgery, a doctor will give a patient instructions which medication the patient must not take prior to surgery (usually aspirin and anti-inflammatory medications because they can affect platelet and blood clotting). The patient must not eat or drink anything, even water, chewing gum or candy 6 hours before surgery.

Parathyroidectomy can be performed at a hospital or at an outpatient surgery center. It usually takes up to three hours. During the procedure, the surgeon will remove on or more parathyroid glands through a small incision and this is called minimally invasive Parathyroidectomy.

After surgery, patients will be in the recovery room for about one hour. Mostly the patients spend one night in the hospital but some patients may go home the same day, but a friend or family member usually is required to pick patients up from the surgical facility.

The patient will have a bandage wrapped around the neck and usually it is removed one or two days after surgery. The neck of the patient can be swollen, bruised and numbed.

The symptoms of low blood calcium are numbness and tingling of the lips, arms, or feet, and or twitching of the muscles and if the patient feels them in any, he/she must contact the surgeon or endocrinologist immediately.

Blood calcium level will be monitored starting several hours after surgery and few days after so if the level falls, the patient will take supplemental oral calcium for several days or weeks following surgery.

Antibiotics can be prescribed after surgery so the patient must finish all the pills that have been ordered and some form of a narcotic pain medication can also be prescribed and is to be taken as needed. Approximately 7 days after surgery sutures will be removed.

The patient can return to work or school when the doctor says and 3 weeks after surgery, the patient can continue with exercising and swimming if there are not any kind of problems.

The patient must inform the doctor immediately if he/she notices a fever greater than 101.5 degrees F which persists after taking acetaminophen, drainage from the wound, a sudden increase in the amount of bruising, pain and swelling of the neck and difficulty breathing and spasms or severe cramps in the muscles of the face.

The possible complications of Parathyroidectomy are rare but they can occur:

  • possible damage to the recurrent laryngeal nerve which runs very close to or through the thyroid gland next to the parathyroid glands and controls movement of the vocal cord on that side of the larynx
  • bleeding during surgery
  • damage to the remaining parathyroid glands so patient may need to take calcium supplementation for the rest of their live
  • recurrence of the tumor and need for further and more aggressive surgery such as total thyroidectomy
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