Our Summary

This study looks at the outcomes of a surgery called parathyroidectomy, which treats a condition called hyperparathyroidism that becomes more common as people age. The researchers divided patients who had this surgery into three age groups: 60 or younger, 61 to 79, and 80 or older. They looked at different outcomes like complications, deaths within 30 days of surgery, having to return to the operating room, how long the surgery took, and how long patients stayed in the hospital.

They found that the oldest group of patients had more complications, stayed in the hospital longer, and had a higher mortality rate. However, after adjusting for factors like gender, race, body mass index, smoking status, steroid use, and level of frailty, they found no significant difference in complications or mortality between the youngest and oldest group of patients.

The researchers also compared these outcomes to patients undergoing a different surgery - an elective inguinal hernia repair. They found that the parathyroidectomy had lower rates of complications and mortality, even in the oldest group of patients.

In simple terms, this study suggests that parathyroidectomy is a safe operation, with less risk and lower death rates than an elective hernia repair surgery, even for patients who are 80 or older.

FAQs

  1. What is a parathyroidectomy and what does it treat?
  2. Was there a significant difference in complication rates or mortality between different age groups who underwent parathyroidectomy?
  3. How do the risks and outcomes of a parathyroidectomy compare to those of an elective inguinal hernia repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about parathyroidectomy is that it is generally a safe procedure with low risk, even for older patients. It is important to discuss any concerns or questions with your healthcare provider before undergoing the surgery. Additionally, following post-operative care instructions and attending follow-up appointments is crucial for a successful recovery.

Suitable For

Patients who are typically recommended for parathyroidectomy are those with hyperparathyroidism, especially if they are experiencing symptoms such as bone pain, kidney stones, fatigue, or weakness. The decision to undergo surgery is typically based on factors such as the severity of the condition, the presence of symptoms, and the overall health of the patient. This study suggests that even older patients, including those who are 80 or older, can safely undergo parathyroidectomy with low rates of complications and mortality.

Timeline

Before parathyroidectomy:

  1. Patient presents with symptoms of hyperparathyroidism, such as fatigue, weakness, bone pain, kidney stones, and high calcium levels in the blood.
  2. Patient undergoes diagnostic tests, such as blood tests, imaging studies, and a sestamibi scan, to confirm the diagnosis and locate the abnormal parathyroid gland.
  3. Surgery is scheduled and the patient undergoes preoperative evaluation and preparation.

After parathyroidectomy:

  1. Patient undergoes the surgery to remove the abnormal parathyroid gland(s).
  2. Postoperatively, the patient is monitored in the recovery room for any immediate complications.
  3. Patient is observed in the hospital for a few days to ensure proper healing and management of calcium levels.
  4. Patient is discharged home with instructions for postoperative care, including monitoring of calcium levels, wound care, and activity restrictions.
  5. Follow-up appointments are scheduled to monitor healing, calcium levels, and overall recovery.
  6. Patient may experience improvement in symptoms related to hyperparathyroidism, such as increased energy levels and resolution of bone pain and kidney stones.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with parathyroidectomy?
  2. How long will the surgery take and how long will I need to stay in the hospital?
  3. What is the success rate of this surgery in treating hyperparathyroidism?
  4. Are there any alternative treatment options for hyperparathyroidism that I should consider?
  5. How experienced are you in performing parathyroidectomy surgeries?
  6. What is the recovery process like after a parathyroidectomy?
  7. Will I need to take any medications or make lifestyle changes after the surgery?
  8. How often will I need to follow up with you after the surgery?
  9. Are there any long-term effects or complications I should be aware of after the surgery?
  10. How does my age impact the potential outcomes of the surgery?

Reference

Authors: Khokar AM, Kuchta KM, Moo-Young TA, Winchester DJ, Prinz RA. Journal: World J Surg. 2020 Feb;44(2):526-536. doi: 10.1007/s00268-019-05280-9. PMID: 31722077