Clinical analysis of parathyroid gland transplantation in subcutaneous tissue of upper abdomen for secondary hyperparathyroidism
10.3760/cma.j.cn421203-20220526-00123
- VernacularTitle:上腹部皮下组织内甲状旁腺移植治疗继发性甲状旁腺功能亢进临床分析
- Author:
Su FENG
1
;
Lina MA
;
Ruihao QIN
;
Gaolei JIA
;
Hailin XI
Author Information
1. 徐州市中心医院甲状腺外科，徐州 221009
- Keywords:
Parathyroidectomy;
Transplantation;
Secondary hyperparathyroidism
- From:
Chinese Journal of Organ Transplantation
2022;43(8):483-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility and effectiveness of parathyroid autotransplantation in subcutaneous tissue of upper abdomen after total parathyroidectomy in patients with severe secondary hyperparathyroidism (SHPT).Methods:From January 2018 to January 2020, retrospective reviews were conducted for clinical data of 29 patients with secondary hyperparathyroidism undergoing epigastric parathyroid autotransplantation after total parathyroidectomy.Clinical and biochemical characteristics were recorded.Serum levels of calcium, phosphorus, parathyroid hormone and alkaline phosphatase before and after operation were analyzed by paired sample t-test and the difference was statistically significant ( P<0.01). The follow-up period was 1, 3, 6 and 12 months post-operation and yearly after 12 months. Results:All operations were successful.The postoperative levels of calcium[(2.25±0.32) vs.(2.49±0.24) mmol/L], phosphorus[(1.72±0.65) vs. (2.09±0.75) mmol/L], alkaline phosphatase[(199.02±77.68) vs.(384.21±154.5) U/L]and parathyroid hormone (PTH)[(8.01±7.00) vs.(1 930.64±620.51) pg/ml]were significantly lower than the preoperative levels ( P<0.01). And the differences were statistically significant.And 17/18 hypertensive patients improved post-operation; postoperative improvement was not obvious for 21 anemic patients, 17 patients improved within 1 year.Among 26 cases with bone pain, 16 cases disappeared immediately postoperatively, 5 disappeared within 1 month and 5 within 3 months.Among 13 cases with skin itch, 10 cases disappeared immediately and 3 cases at 1 month post-operation.The level of PTH recovered at different follow-up timepoints with an average recovery time of (4.45±2.31) months. Conclusions:Autologous transplantation of parathyroid gland in epigastric subcutaneous tissue after parathyroidectomy is both safe and effective for secondary hyperparathyroidism.
