Clinical Profile, Diagnostics, and Short-term Outcomes of Parathyroid Surgery for Hyperparathyroidism in a Tertiary Hospital in the Philippines: A Retrospective Study

Abstract

Objective. This study aimed to describe the demographics, clinical presentations, diagnostic workup, and shortterm biochemical outcomes of parathyroidectomy among patients with hyperparathyroidism in a tertiary hospital in the Philippines.

Methods. A retrospective review of patients who underwent parathyroidectomy in the University of the PhilippinesPhilippine General Hospital from 2014 to 2021 was done. Demographics, symptoms, laboratory and imaging findings, surgical approach, and post-operative outcomes were recorded. Descriptive statistics and paired t-tests were used for analysis.

Results. Thirty-two patients underwent surgery: 23 had primary, six had secondary, and 3 had tertiary hyperparathyroidism. The mean age was 47 years, and 72% were female. The average symptom duration before surgery was 24 months. Bone pain was the most frequent symptom, and five patients presented with brown tumors. Pre-operative laboratory evaluation showed severe hypercalcemia and markedly elevated iPTH, especially in primary HPT. Sestamibi scans were the most commonly used imaging modality (84%). Surgery resolved hypercalcemia in 95.2% and normalized iPTH in 93.8% of patients. No complications were recorded within 30 days post-operatively.

Conclusion. Parathyroidectomy is an effective and safe treatment strategy in achieving normal PTH levels among patients with hyperparathyroidism. Patients with hyperparathyroidism in this study underwent surgery late in the course of the disease process. Strategies must be employed to promote earlier diagnosis and subsequent treatment. Further studies with larger population sizes are recommended to investigate the long-term outcomes of operated HPT patients.