{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T06:34:13Z","timestamp":1794033253289,"version":"4.8.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2008,1,20]],"date-time":"2008-01-20T00:00:00Z","timestamp":1200787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Primary hyperparathyroidism (PHPT) is increasingly being recognized in the developing world, but long\u2010term recovery of affected organs after successful parathyroidectomy, remains unaddressed. A study was therefore undertaken to elucidate this aspect of care among our patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis was done on 82\u00a0PHPT patients who underwent parathyroidectomy between 1991 and 2004. Appropriate biochemical and radiological investigations revealed the recovery pattern in target organs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Follow\u2010up ranged between 2 years and 13 years. Bone pain and muscle weakness disappeared quickly in all patients. Radiographs revealed vigorous but disorderly remineralization in lesions that healed within a median period of 3\u00a0months. Mean 25\u2010OH vitamin D levels in the preoperative and postoperative period were 11.6 \u00b1 8.7 and 16.94 \u00b1 12.77\u00a0ng\/ml, respectively. Twenty\u2010four of 32 (75%) patients remained persistently vitamin D deficient (mean level 12.15 \u00b1 5.45\u00a0ng\/ml) postoperatively and in the long term (2\u201313 years; median: 3 years). Kidney disease occurred in 43 patients, and 74% of them became symptom free; in 9 patients it remained static and in 3 others it progressed to end\u2010stage renal disease (ESRD). Seven patients had pancreatitis, 5 became symptom free, and 2 had no relief after failed exploration (<jats:italic>n<\/jats:italic> = 1) and recurrence (<jats:italic>n<\/jats:italic> = 1). Overall recurrence and persistence rates were 2.7% each. Of the 5 deaths in the follow\u2010up period, three were due to ESRD and one was due to cerebral metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In India, PHPT presents at an advanced stage and is associated with vitamin D deficiency. Persistent vitamin D deficiency after operation delays bone recovery. Replenishment of vitamin D stores in the follow\u2010up has to be continuously ensured. Recovery from renal disease is gradual and may never occur in some patients; in others, it may progress to ESRD. Patients recover fully from pancreatitis.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-007-9384-9","type":"journal-article","created":{"date-parts":[[2008,1,19]],"date-time":"2008-01-19T21:06:50Z","timestamp":1200776810000},"page":"829-835","source":"Crossref","is-referenced-by-count":31,"title":["Long\u2010term Outcome after Parathyroidectomy in Patients with Advanced Primary Hyperparathyroidism and Associated Vitamin D Deficiency"],"prefix":"10.1002","volume":"32","author":[{"given":"P. V.","family":"Pradeep","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Rae\u2010Bareillei Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Rae\u2010Bareillei Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Rae\u2010Bareillei Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Rae\u2010Bareillei Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. K.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Rae\u2010Bareillei Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, and SGPGI Telemedicine Program Sanjay Gandhi Postgraduate Institute of Medical Sciences Rae\u2010Bareillei Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,1,20]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp032200"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910213411701"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007\u20101323.2001.01775.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012098651-4\/50024-9"},{"key":"e_1_2_6_6_2","first-page":"194","article-title":"Bone and renal stone disease in patients operated for primary hyperparathyroidism in Pakistan: is the pattern of disease different from the West?","volume":"49","author":"Biyabani 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