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Resumen Introduccion El hiperparatiroidismo primario es la tercera enfermedad endocrina mas frecuente. El objetivo de este estudio fue determinar los resultados a largo plazo y los factores de riesgo de persistencia en pacientes operados por hiperparatiroidismo primario. Metodos Estudio retrospectivo de pacientes operados de paratiroidectomia entre 2009-2019. Se definio cura como el restablecimiento de la homeostasis normal del calcio durante un minimo de seis meses, persistencia como la continuidad de hipercalcemia por mas de seis meses postoperatorios, y recurrencia como la reaparicion de hipercalcemia luego de un intervalo normocalcemico mayor a seis meses postoperatorios. Se realizo un analisis mas detallado en pacientes con normocalcemia y hormona paratiroidea (HPT) elevada postoperatoria. Las variables independientemente relacionadas a persistencia fueron analizadas mediante analisis multivariante. Resultados Se incluyeron 212 pacientes. La edad media fue 59 anos y 83% fueron mujeres. Se observo cura en 204 pacientes (96,2%), persistencia en ocho (3,8%) y recurrencia en tres (1,4%). Cuatro pacientes (1,9%) presentaron normocalcemia y HPT persistentemente elevada luego de la cirugia. Todos presentaron patologia paratiroidea (dos adenoma y dos hiperplasia). En el seguimiento se observaron tres pacientes con fallo renal cronico (FRC) y uno con deficit de vitamina D. La persistencia se asocio independientemente con hiperplasia (Odds ratio=12,6; IC 95%: 1,28-124; p = 0,030) y tejido paratiroideo normal (Odds ratio=188; IC 95%: 9,33- 379; p = 0,001) en el estudio histopatologico. Conclusion La paratiroidectomia es un procedimiento seguro en terminos de morbilidad y resultados a largo plazo. La hiperplasia y el tejido paratiroideo normal en el estudio histopatologico son factores de riesgo de persistencia.

Primary hyperparathyroidism is the third most common endocrine disease. The aim of our study was to determine long-term outcomes and risk factors for persistence in patients undergoing parathyroidectomy for primary hyperparathyroidism.Retrospective study including patients undergoing parathyroidectomy between 2009- 2019. Cure was defined as reestablishment of normal calcium homeostasis lasting a minimum of 6 months. Persistence was defined by ongoing hypercalcemia more than 6 months after surgery. Recurrent PHTP was defined by recurrence of hypercalcemia after a normocalcemic interval at more than 6 months after surgery. A more detailed analysis was performed on patients with normocalcemia and persistently elevated PTH levels after surgery. Variables independently related to persistence were analyzed by multivariate analysis.We included 212 patients. Mean age was 59 years and 83% were women. Cure was observed in 204 patients (96.2%), persistence in 8 (3.8%) and recurrence in 3 (1.4%). Four patients (1.9%) presented normocalcemia and persistently elevated PTH after surgery. All presented parathyroid pathology (2 adenomas and 2 hyperplasia). In follow-up we observed that adenoma subgroup presented one patient with CKD and one with vitamin D deficiency while in the hyperplasia subgroup two patients presented CKD. Persistence was independently associated with hyperplasia (Odds ratio=12.6, IC95%=1.28-124, p=0.030) and normal parathyroid tissue (Odds ratio=188, IC95%=9.33-379, p=0.001) on histopathological report. CONCLUSIóN: Primary hyperparathyroidism is a safe procedure in terms of morbidity and long-term outcomes. Hyperplasia and normal parathyroid tissue on histopathological report are risk factors for persistence. An interdisciplinary diagnostic and therapeutic approach is required to prevent persistence.