open access

Vol 67, No 2 (2016)
Original papers
Published online: 2016-01-19
Submitted: 2015-04-25
Accepted: 2015-06-25
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Subtotal parathyroidectomy versus total parathyroidectomy with autotransplant in secondary hyperparathyroidism — a single center prospective cohort of 43 patients

Radu Mircea Neagoe, Mircea Mureșan, Septimiu Voidăzan, Ionela Pașcanu, Cristina Pop Radu, Daniela Tatiana Sala
DOI: 10.5603/EP.a2016.0013
·
Endokrynologia Polska 2016;67(2):202-209.

open access

Vol 67, No 2 (2016)
Original papers
Published online: 2016-01-19
Submitted: 2015-04-25
Accepted: 2015-06-25

Abstract

Introduction: The need for parathyroidectomy remains high in the group of patients on long-term dialysis with medically refractory secondary hyperparathyroidism (sHPT). We aim to compare the results after subtotal parathyroidectomies (sPtx) and total parathyroidectomies with autotransplant (tPtx + AT) performed for sHPT at a single referral centre.

Material and methods: This prospective study comparatively analysed sPtx and tPtx + AT performed in our department between February 2010 and December 2014. We followed-up both surgical techniques, with respect to the main clinical symptoms, laboratory data, mortality, and recurrent disease.

Results: Forty-three patients on whom we performed 26 sPtx and 19 tPtx + AT were entered in the study. There were no statistically significant differences between groups as far as demographic and preoperative clinical data are concerned. We did not encounter postoperative mortality in either of the groups. The follow-up period was significantly longer for the sPtx group (p = 0.04). The immediate postoperative serum calcium levels were significantly lower in the tPtx + AT group (p = 0.009). Definitive hypoparathyroidism was encountered in two patients in the sPtx group (8.3%) and in one from the tPtx + AT group (5.26%). Four patients from the sPtx group (16.6%) and three from the tPtx + AT group (15.78%) died during the follow-up due to causes unrelated to parathyroidectomy. Overall we had two recurrences in the sPtx group and none in the tPtx + AT group (p = 0.57).

Conclusions: In our opinion both techniques have comparable results concerning the clinical and laboratory outcomes and rates of postoperative hypoparathyroidism, at least in short- and medium-term follow-up. (Endokrynol Pol 2016; 67 (2): 202–209)

Abstract

Introduction: The need for parathyroidectomy remains high in the group of patients on long-term dialysis with medically refractory secondary hyperparathyroidism (sHPT). We aim to compare the results after subtotal parathyroidectomies (sPtx) and total parathyroidectomies with autotransplant (tPtx + AT) performed for sHPT at a single referral centre.

Material and methods: This prospective study comparatively analysed sPtx and tPtx + AT performed in our department between February 2010 and December 2014. We followed-up both surgical techniques, with respect to the main clinical symptoms, laboratory data, mortality, and recurrent disease.

Results: Forty-three patients on whom we performed 26 sPtx and 19 tPtx + AT were entered in the study. There were no statistically significant differences between groups as far as demographic and preoperative clinical data are concerned. We did not encounter postoperative mortality in either of the groups. The follow-up period was significantly longer for the sPtx group (p = 0.04). The immediate postoperative serum calcium levels were significantly lower in the tPtx + AT group (p = 0.009). Definitive hypoparathyroidism was encountered in two patients in the sPtx group (8.3%) and in one from the tPtx + AT group (5.26%). Four patients from the sPtx group (16.6%) and three from the tPtx + AT group (15.78%) died during the follow-up due to causes unrelated to parathyroidectomy. Overall we had two recurrences in the sPtx group and none in the tPtx + AT group (p = 0.57).

Conclusions: In our opinion both techniques have comparable results concerning the clinical and laboratory outcomes and rates of postoperative hypoparathyroidism, at least in short- and medium-term follow-up. (Endokrynol Pol 2016; 67 (2): 202–209)

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Keywords

subtotal parathyroidectomy; total parathyroidectomy; autotransplant

About this article
Title

Subtotal parathyroidectomy versus total parathyroidectomy with autotransplant in secondary hyperparathyroidism — a single center prospective cohort of 43 patients

Journal

Endokrynologia Polska

Issue

Vol 67, No 2 (2016)

Pages

202-209

Published online

2016-01-19

DOI

10.5603/EP.a2016.0013

Bibliographic record

Endokrynologia Polska 2016;67(2):202-209.

Keywords

subtotal parathyroidectomy
total parathyroidectomy
autotransplant

Authors

Radu Mircea Neagoe
Mircea Mureșan
Septimiu Voidăzan
Ionela Pașcanu
Cristina Pop Radu
Daniela Tatiana Sala

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