The authors present their own experience with the surgical treatment of hyperparathyroidism. In the course of five years - from the beginning of 1996 to the end of 2000 they p erformed 49 operations on account of hyperparathyroidism in 48 subjects. The patients’ age was within the range of 17-76 years with an average of 53 years. Women predominated over men, the ratio being 4:1. Three patients were recommended for surgery by an endocrinologist, or a nephrologist in case of tertiary hyperparathyroidism (hyperplasia of all parathyroid bodies), in the remaining 45 subjects primary hyperparathyroidism was involved. As to imaging methods, before surgery most frequently ultrasound was used - in 100% (sensitivity 90%), the second most frequently used examination was scintigraphy (MBI scan) with a sensitivity of 88%. In 45% patients with adenoma of the parathyroid unilateral revision with removal of an adenoma was performed or removal of another ipsilateral body. In three patients with tertiary hyperparathyroidism and hyperplasia of all bodies the authors selected subtotal parathyroidectomy with preservation of one body, or a complete procedure with implantation of one body into the musculature of the forearm. In case of nodular reconstruction of the thyroid gland surgery was combined with an appropriate operation of the thyroid gland (most frequently lobectomy on the side of the adenoma of the parathyroid body). Complete cure of hyperparathyroidism (elimination of clinical and laboratory signs of hypercalcaemia) was achieved in 45 patients (94%). Reoperation was necessary in one instance in a female patient with a multiple adenoma of the parathyroid gland. In three patients (6%) hypercalcaemia persists also after surgery. As to possible complications the authors recorded temporary paresis of the recurrent nerve in four patients (8%). Permanent paresis of the recurrent nerve developed in two patients (4%). In one female patient with a paraoesophageal localization of an adenoma of the parathyroid gland during operation perforation of the oesophagus occurred. The authors pay attention to the anatomy and pathology of the parathroid glands, discuss views on the indication and technique of surgical treatment of hyperparathyroidism.

        Key words: hypercalcaemia, hyperparathyroidism, surgical treatment.