J.Jpn. Surg. Soc.. 78(5): 408-422, 1977

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Original article

CLINICAL AND EXPERIMENTAL STUDIES ON EARLY POSTOPERATIVE MANAGEMENT OF PRIMARY HYPERPARATHYROIDISM

In early postoperative courses of primary hyperparathyroidism, it is very important to determine whether a parathyroidectomy will be successful, and then to give proper medical treatment to these postoperative hypoparathyroid patients.
Thirty-two cases of proven primary hyperparathyroidism with their experimental results were followed up and reviewed in the studies presented in this paper.
Serum ca-levels in all successful patients fell to normal range values within 48 hours postoperatively, these ca-levels continues to fall to subnormal levels, but returned to normalcy in about two months. The unsuccessful cases' ca-levels returned to high range values within the 10th postoperative day.
It was demonstrated that if overdoses of calcium were administered to surgical hypoparathyroid animals the recovery of the animal's parathyroid function was delayed. Therefore calcium should only be given to patients who develope symptoms of sever hypocalcemia.
Severe hypocalcemic sings are predictable in patients who have bone complaits, high Al-p levels, whose, serum ca-levels fall below 7.5 mg/dl in the 3rd postoperative day, and whose hypocalcemic signs are initiated within 12 hours. Calcium should be administered, however, to patients who have significant bone-demineralization on X-ray, or demonstrate congestive cardiac failure due to postoperative hypocalcemia.

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