AI Article Synopsis
- - This study evaluates the outcomes of total parathyroidectomy (TPX) without autotransplantation in patients with end-stage renal disease (ESRD) who underwent surgery for secondary hyperparathyroidism.
- - Among the 34 patients analyzed, the rates of recurrent hyperparathyroidism were low at 5.9%, with persistent cases at 11.8%; no patients experienced severe complications like hypocalcemia or bone fractures.
- - The findings suggest that TPX is effective for treating hyperparathyroidism, particularly highlighting that operating on four glands may reduce the likelihood of recurrence.
Article Abstract
Background: The most common operations performed for secondary hyperparathyroidism include subtotal parathyroidectomy (STPX) and total parathyroidectomy with autotransplantation (TPX + AT). We present a series of ESRD patients treated with total parathyroidectomy without autotransplantation (TPX).
Methods: This is a retrospective cohort analysis of ESRD patients, age 18 years or older, with three or more glands resected on final pathology and follow-up parathyroid hormone levels obtained up to 1.5 years postoperatively. The primary endpoint was recurrence of hyperparathyroidism (defined as PTH > 500 pg/mL).
Results: The incidence of recurrent hyperparathyroidism at 1.5 years was 5.9% (2/34). The incidence of persistent hyperparathyroidism at 1.5 years was 11.8% (4/34). In this series, no patients were hospitalized for symptomatic hypocalcemia or experienced pathologic bone fractures.
Conclusions: Recurrence rates are low with TPX. The most common cause of recurrent and persistent disease is resection of three rather than four glands. The known complications of TPX, pathologic fractures, and severe hypocalcemia, were not seen in this study.
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| http://dx.doi.org/10.1177/00031348221148364 | DOI Listing |
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