Parathyroid Surgery

Parathyroid glands are several small oval glands located behind the thyroid. They secrete the parathyroid hormone which controls and regulates the calcium levels in the body. 1 in 100 people will develop a parathyroid gland tumor in their lifetime. These tumors cause the parathyroid disease known as hyperparathyroidism. Surgery is the only way to treat parathyroid disease. The tumor/tumors must be removed by a surgeon. When the surgery is performed by an experienced endocrine surgeon, the operation is successful in about 95% percent of cases.

parathyroidLike all surgical procedures, there are some risks involved. Risks of blood loss, infection, injury to the laryngeal nerves which control the vocal cords are present but very little. There is also the possibility that abnormal glands could not be located or that your symptoms reoccur over time. Sometimes the ailment known as hypoparathyroidism may result after surgery. This condition causes low calcium levels and may require supplements of calcium and vitamin D to maintain normal calcium levels. A small amount of risk is also associated with anesthesia. However, the overall risks of complications are low and are usually outweighed by the benefits surgery will bring.

Pre-Op for Parathyroid Surgery

Before you see a surgeon, you may need to go through a series of tests that will evaluate your parathyroid glands. Ultrasounds, sestamibi scans, and CT scans provide surgeons with useful information about your parathyroid glands. Routine blood work is also necessary. Depending on the results of the blood work some patients need to take vitamin D before surgery. More general screening tests are done one to two weeks before the surgery. Depending on your history and blood work you may also need an EKG, chest X-ray, and a stress test. These tests will evaluate your heart and lung function and do not require a hospital stay. You may meet with a high-risk anesthesiologist depending on your age and health. You may also meet with an endocrine nurse practitioner, who will explain the operation to you and make sure the appropriate testing has been taken care of.

Minimally invasive parathyroid surgery, which involves small incisions and the help of a camera, is the safest and most common version of parathyroid surgery, although some places still perform the ‘old fashioned’ standard surgery which involves the surgeon exploring for the parathyroid glands after making two incisions on either side of the neck. The operation can take between 3 and 6 hours. It can take longer or shorter depending on the experience level of the surgeon. Cure rate also depends on the experience of the surgeon, as do the expected risks, complications, blood loss, and duration of the surgery. Make sure that you get a surgeon with experience and confidence with parathyroid glands, as they are difficult to find in the body. If your surgeon only does a few parathyroid operations a year, there is a good chance (15%) you will need a second operation performed by an expert. Parathyroid experts typically perform one re-do operation a week because the previous surgeon was unable to fix the problem.

Post-Op for Parathyroid Surgery

parathyroidRecovery typically takes one to two weeks. The most common complaint after surgery is fatigue, sore throat, and generalized soreness which usually disappears after a week or two. After surgery, there is no restriction on what you can eat or drink. However, some people experience a sore throat and stick to softer foods for a few days. It is important to stay away from heavy, greasy, or spicy foods for the first few days following surgery. Light activity such as walking is encouraged to help speed up recovery, along with gentle neck exercises to help with neck stiffness. Avoid showering for 24-48 hours after surgery, and stay away from swimming, baths, and hot tubs for two weeks. Keeping out of direct sunlight for a year after surgery along with using sunscreen with at least SPF 15  will help maintain the scar and keep it from darkening too much.





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