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Scientific Oral Presentation

Endocrine Surgery

Subtotal Parathyroidectomy for Primary Hyperparathyroidism – a Safe & Effective Intervention

Sunday, October 18, 2026
1:54 PM - 2:00 PM PT
Location: Theatre 411

    Presenting Author(s)

  • Brendan M. Dolan, BA

    Medical Student
    Wayne State University School of Medicine
    Detroit, MI, United States

    • Senior Author(s)

  • MS

    Michael C. Singer, MD

    Director, Thyroid & Parathyroid Surgery
    Henry Ford Health
    Huntington Woods, MI, United States

Disclosure(s):
Brendan M. Dolan, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Primary hyperparathyroidism (PHPT) due to multiglandular disease represents a significant challenge for surgeons. Hyperplasia, in which all parathyroid glands are involved, requires a subtotal parathyroidectomy for management. This surgery is precarious, as under-resection of glandular tissue can result in surgical failure or early recurrence and over-resection can lead to permanent hypoparathyroidism. To date, limited outcomes data have been reported for patients treated with a subtotal parathyroidectomy for non-syndromic, PHPT.

Methods: A retrospective review of patients who underwent a subtotal parathyroidectomy from August 2014 to March 2024 for non-syndromic PHPT. Primary outcomes assessed were cure, recurrence, and hypocalcemia lasting ≥ 6 months postoperatively. Cure was defined as maintenance of eucalcemia for ≥ 6 months following surgery. All patients had first-time surgery for classical or normohormonal PHPT and ≥ 6 months of follow-up data. Normocalcemic PHPT and reoperative surgery were exclusion criteria in this study.

Results: Records were available for 984 patients. 83 (8.4%) required a subtotal parathyroidectomy, with median follow-up of 1,264 days (range 374-3,524). 77/83 had >1 year of follow-up data. Of these, 1 patient experienced permanent hypoparathyroidism and 1 developed a recurrence after a 5-year period. At surgery, intraoperative parathyroid hormone (ioPTH) levels decreased by a mean of 85.1% (SD = 11.1%), with 14/83 reaching undetectable levels. Normohormonal hyperparathyroidism represented 19.2% of the patients who required a subtotal parathyroidectomy.

Conclusions: In a large cohort of patients with non-syndromic PHPT, a substantial percentage required a subtotal parathyroidectomy to achieve a cure. This approach appears safe, with a low incidence of permanent hypoparathyroidism, while also providing an enduring cure. Marked drops in ioPTH levels, frequently below the detectable range, can be expected at the time of surgery. Ongoing analyses will compare these results with single-gland parathyroidectomy patients from the same dataset.