Application of total parathyroidectomy without autotransplantation in refractory secondary hyperparathyroidism
10.3969/j.issn.1009-9905.2017.05.002
- VernacularTitle:无自体移植的甲状旁腺全切除术在难治性继发性甲状旁腺功能亢进中的应用
- Author:
Meng YANG
;
Ling ZHANG
;
Linping HUANG
;
Xiaoliang SUN
;
Jun LIU
;
Haoyang JI
;
Yao LU
- Keywords:
Secondary hyperparathyroidism;
Total parathyroidectomy without autotransplantation
- From:
Chinese Journal of Current Advances in General Surgery
2017;20(5):342-345
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical outcome and feasibility for patients who underwent total parathyroidectomy without autotransplantation (TPTX) for secondary hyperparathyroidism (SHPT).Methods:From April 2012 to December 2015,220 SHPT patients underwent TPTX in the department of Breast and Thyroid Surgery of China-Japan Friendship Hospital.The clinical data and effect were assessed retrospectively.Results:All the 220 patients were on permanent dialysis with mean duration of dialysis (7.93 ± 3.75) years.A durable reduction in mean PTH,Ca and P were observed after TPTX (P＜0.01).The mean hospital stay was (7.8 ± 2.8) days.TPTX produced a rapid improvement in clinical symptoms.Incidence of hypocalcemia was 73.46％.Severe complications such as recurrent laryngeal nerve palsy or inactive dynamic osteopathia,haven't been observed postoperatively.The rate of persistent status (PTH≥300 pg/mL) was 9.1％.One (0.45％) died of infectious shock perioperatively.Conclusions:TPTX was a safe and feasible surgical procedure for patients with SHPT.It was worth of being applied.Not missing the parathyroid during operation was the key point for successful TPTX.Intensive monitoring and maintaining stable normocalcemia were the key point to reduce complication.
