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Reoperation for persistent and recurrent hyperparathyroidism.

As a consequence of an experience with 175 patients undergoing reoperation for persistent or recurrent hyperparathyroidism, the authors have evolved an approach to management. The emphasis is on the confirmation of the diagnosis; the critical evaluation of invasive and noninvasive localization tests, techniques of intraoperative assessment as to the adequacy of the reexploration; the avoidance of postoperative complications; the treatment with cryopreserved autografts of persistent hypocalcemia. With this approach, the authors have had a success rate of greater than 90% for reexploration in patients with persistent and recurrent hyperparathyroidism.