Long-term results of unilateral neck exploration for preoperatively localized nonfamilial parathyroid adenomas

BACKGROUND: Unilateral neck exploration for sporadic parathyroid adenomas remains a contentious policy. The morbidity is lower than for bilateral surgery, but the long-term outcome may be inferior. METHODS: The results of a policy of unilateral neck exploration for primary hyperparathyroidism based on preoperative localization are reviewed. RESULTS: Over a 10-year period, 89 patients were operated on, 57 undergoing unilateral neck exploration. Unilateral neck exploration significantly reduced operative time (P <0.0001) and postoperative hypocalcaemia (P = 0.021). Over a mean biochemical follow-up of 38 months, recurrent hypercalcaemia occurred in 6% of patients, including 3.5% of those undergoing unilateral neck exploration, an additional 10% of patients were normocalcaemic with an inappropriately elevated parathormone level. CONCLUSIONS: A policy of unilateral neck exploration can achieve comparable long-term results to more extensive bilateral surgery.