Autograft function by pathological types after total parathyroidectomy in patients of hyperthyroidism
10.3760/cma.j.cn113855-20221029-00664
- VernacularTitle:不同病理形态的自体移植物在甲状旁腺全切除加自体移植术后的效果评价
- Author:
Hao LI
1
;
Huayu LI
;
Jingyi FANG
;
Shaohua SUN
;
Feng SHEN
;
Dazheng FANG
Author Information
1. 湖北医药学院附属国药东风总医院甲状腺诊疗中心，十堰 442000
- Keywords:
Hyperparathyroidism, secondary;
Transplants;
Kidney failure，chronic;
Parathyroidectomy
- From:
Chinese Journal of General Surgery
2024;39(5):367-371
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate alteration of autograft function by pathological types after total parathyroidectomy (tPTX) plus autotransplantation (AT) in patients of hyperthyroidism.Methods:A total of 51 patients with end-stage chronic renal failure who underwent total parathyroidectomy with autologous forearm transplantation from Mar 2017 to Feb 2021 were divided into chief cell type (CC) and oxyphil cell type (OC) according to dominating graft cell type. iPTH, calcium, phosphorus and ALP levels were compared between the two groups from the perioperative period to 6 months and the 3D ultrasonography was performed at 6 months to cocalculate the size of the autograft.Results:Between the two groups, there were no statistically significant differences in iPTH, blood calcium, blood phosphorus, or ALP levels pre-,and 30 minutes, one month post surgery (all P>0.05). On three months, there was no significant difference in ALP levels [CC group: (99±23) U/L, OC group: (89±35) U/L, t=0.776, P=0.442]. At 6 months the PTH level [CC group: (290±77) pg/ml, OC group: (246±59) pg/ml, t=2.034, P=0.047], and blood calcium [CC group: (2.62±0.65) mmol/L, OC group: (2.21±0.20) mmol/L, t=2.531, P=0.015] blood phosphorus [CC group: (1.38±0.28) mmol/L, OC group: (1.68±0.34) mmol/L; t=-3.269, P=0.002], were all in favor of CC group. By 3D ultrasnography at 6 months the size of autograft was larger in CC group than in OC group [V cc=(2.17±0.37) cm 3,V oc=(1.85±0.29) cm 3, t=3.172, P<0.05]. Recurrences at 1 year after surgery were not significantly different between the two groups ( ncc=3, noc=1, t=0.277, P>0.05). Conclusion:The biological activity of CC-type grafts is higher than that of OC suggesting a longer functioning period as a parathyroid autograft.
