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Total parathyroidectomy without autotransplantation in dialysis patients and renal transplant recipients, long-term follow-up evaluation.

AbstractBACKGROUND:
Persistent secondary hyperparathyroidism not responding to medication is treated successfully with surgical excision of parathyroid glands (total parathyroidectomy [PTX]). PTX without autotransplantation of parathyroid glands excludes the risk for recurrence of hyperparathyroidism.
METHODS:
During the years 2002 to 2005, 36 total parathyroidectomies were performed in 33 patients: 21 dialysis patients because of end-stage renal disease and 12 renal transplant recipients.
RESULTS:
PTX without autotransplantation was performed successfully in 33 patients, whereas 3 patients were reoperated for remaining parathyroid glands. Immediate improvement of clinical symptoms and a decrease of serum calcium and parathormone levels were observed after surgical procedures. Oral replacement treatment with vitamin D (1a-calcidiol) and calcium was commenced and long-term follow-up evaluation (23.5 +/- 7.6 mo) showed that calcium homeostasis was controlled adequately.
CONCLUSIONS:
PTX without autotransplantation is a safe and effective surgical procedure for the treatment of resistant secondary hyperparathyroidism with immediate response of clinical symptoms. Replacement treatment with vitamin D and calcium provides satisfactory coverage of individual needs.
AuthorsSpiros Drakopoulos, Maria Koukoulaki, Theofanis Apostolou, Dimitrios Pistolas, Katerina Balaska, Stylianos Gavriil, Valsamakis Hadjiconstantinou
JournalAmerican journal of surgery (Am J Surg) Vol. 198 Issue 2 Pg. 178-83 (Aug 2009) ISSN: 1879-1883 [Electronic] United States
PMID19217601 (Publication Type: Journal Article)
Chemical References
  • Parathyroid Hormone
  • Phosphorus
  • Alkaline Phosphatase
  • Calcium
Topics
  • Alkaline Phosphatase (blood)
  • Arthralgia (etiology)
  • Calcinosis (etiology)
  • Calcium (blood)
  • Drug Resistance
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperparathyroidism, Secondary (complications, surgery)
  • Kidney Failure, Chronic (complications, therapy)
  • Liver Transplantation
  • Male
  • Middle Aged
  • Muscle Weakness (etiology)
  • Parathyroid Glands (pathology)
  • Parathyroid Hormone (blood)
  • Parathyroidectomy
  • Phosphorus (blood)
  • Pruritus (etiology)
  • Renal Dialysis

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