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10.1007/s00423-016-1447-7

http://scihub22266oqcxt.onion/10.1007/s00423-016-1447-7
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C5086343!5086343!27233241
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suck abstract from ncbi


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pmid27233241      Langenbecks+Arch+Surg 2016 ; 401 (7): 965-74
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  • Subtotal parathyroidectomy for secondary renal hyperparathyroidism: a 20-year surgical outcome study #MMPMID27233241
  • Konturek A; Barczy?ski M; Stopa M; Nowak W
  • Langenbecks Arch Surg 2016[]; 401 (7): 965-74 PMID27233241show ga
  • Aim: The aim of this study was to evaluate the outcomes of surgery for patients with secondary renal hyperparathyroidism (rHPT). Methods: This is a retrospective cohort study. Our institutional database was searched for eligible patients treated in 1995?2014. The inclusion criterion was initial parathyroidectomy for rHPT. Clinical and follow-up data were analyzed to estimate the cure rate (primary outcome), and morbidity (secondary outcome). Results: The study group comprised 297 patients (154 females, age 44.5?±?13.7 years, follow-up 24.6?±?10.5 months), including 268 (90.2 %) patients who had underwent subtotal parathyroidectomy, and 29 (9.8 %) who had had incomplete parathyroidectomy. Intraoperative iPTH assay was utilized in 207 (69.7 %) explorations. Persistent rHPT occurred in 12/268 (4.5 %) patients after subtotal parathyroidectomy and 5/29 (17.2 %) subjects after incomplete parathyroidectomy (p?=?0.005). The patients operated on with intraoperative iPTH assay had a higher cure rate than non-monitored individuals, 201/207 (97.1 %) vs. 79/90 (87.8 %), respectively (p?=?0.001). In-hospital mortality occurred in 1/297 (0.3 %) patient. The hungry bone syndrome occurred in 84/268 (31.3 %) patients after subtotal parathyroidectomy and 2/29 (6.9 %) subjects after incomplete parathyroidectomy (p?=?0.006). Transient recurrent laryngeal nerve paresis occurred in 14/594 (2.4 %) and permanent in 5/594 (0.8 %) nerves at risk. Conclusions: Subtotal parathyroidectomy is a safe and efficacious treatment for patients with rHPT. Utilization of intraoperative iPTH assay can guide surgical exploration and improve the cure rate.
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