Total parathyroidectomy in the treatment of chronic renal failure complicating secondary hyperparathyroidism
10.3760/cma.j.cn113855-20220825-00530
- VernacularTitle:甲状旁腺全切除术在慢性肾功能衰竭继发性甲状旁腺功能亢进症治疗中的应用
- Author:
Linfeng WEI
1
;
Runsheng LI
;
Hui ZHAO
;
Xin ZHENG
;
Zhihui DENG
;
Zhongwei SUN
;
Zhuangjie XING
Author Information
1. 大连大学附属中山医院普通外科，大连 116001
- Keywords:
Hyperparathyroidism, secondary;
Parathyroidectomy;
Kidney failure,chronic;
Parathyroid hormone
- From:
Chinese Journal of General Surgery
2023;38(10):749-753
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To comparae the accuracy of imaging examination in preoperative parathyroid localization, and the safety and effect of total parathyroidectomy on secondary hyperparathyroidism complicated by chronic renal failure.Method:A total of 257 patients with secondary hyperparathyroidism who underwent total parathyroidectomy at the Department of General Surgery , Zhongshan Hospital, Dalian University from Mar 2012 to Mar 2022 were analyzed retrospectively.Result:Six hundred fourty parathyroid glands were found by color Doppler ultrasound and 954 parathyroid glands were by enhanced CT before the operation. Among them, the number of patients with accurate location of all 4 parathyroid glands by color Doppler ultrasound was 54, while that by enhanced CT was 216. The parathyroid detection rate by enhanced CT was significantly higher than that of color Doppler ultrasound ( χ2=325.480, P<0.001), and the accuracy rate was significantly higher tnan that of color ultrasound ( χ2=215.146, P<0.001). The average values of iPTH before operation, on the day after operation, on the 1st day and 7th day after operation were (1 880±890), (137±82), (66±46) and (34±23) pg/ml, respectively. The clinical symptoms of all patients were significantly relieved. Conclusions:Enhanced CT is superior to color Doppler ultrasound in the overall detection rate and individual localization accuracy of preoperative parathyroid localization. Total parathyroidectomy is safe and reliable in the treatment of secondary hyperparathyroidism complicated by chronic renal failure.
