Indications for parathyroid surgery

The traditional reasons for parathyroid surgery in primary hyperparathyroidism are listed below:

  1. Hypercalcaemia in all patients below 50 years
  2. Hypercalcaemia greater than 3.00 mmol/l in all age groups
  3. Symptomatic hypercalcaemia in all age groups
  4. Deterioration in renal function
  5. Progressive reduction in bone density
  6. Excessive excretion of calcium in the urine
  7. Any suggestion of malignant parathyroid disease.

The advent of minimally invasive parathyroid surgery with its associated safety and minimal complications has made the indications more liberal.