PRIMARY HYPERPARATHYROIDISM – MANAGEMENT OPTIONS SURGERY Parathyroidectomy remains the only definitive treatment for primary hyperparathyroidism (PHPT). It offers immediate and radical cure from the disease. In experienced hands, it is associated with a very low morbidity. Currently, with the availability of preoperative localization studies (typically high-resolution neck ultrasonography and parathyroid scintigraphy [sestamibi scan]), minimally invasive parathyroidectomy (MIP) is the preferred surgical approach in the majority of cases. MIP has many advantages over the classical neck exploration (bilateral approach). CONSERVATIVE TREATMENT Conservative treatment may be preferred for patients who are poor surgical candidates or those who refuse surgical treatment. Conservative treatment includes surveillance, often associated with the use of some medications. Surveillance strategy Every 1 year (annually) - assessment of: Serum calcium Serum creatinine Esti...
