Total parathyroidectomy with forearm autotransplantation in treatment of secondary hyperparathyroidism

doi:10.16139/j.1007-9610.2022.04.014

Abstract

Abstract:

Objective To analyze the clinical effect of total parathyroidectomy with forearm autotransplantation on secondary hyperparathyroidism. Methods From January 2017 to December 2020, calcium, phosphorus, intact parathyroid hormone, alkaline phosphatase and clinical symptoms of 26 patients who received total parathyroidectomy with forearm autotransplantation in our hospital were studied. The patients with end-stage renal disease in this study had persistent dialysis in the treatment of secondary hyperparathyroidism before admission. Results A total of 105 parathyroid glands of all patients were removed. The symptoms including ostalgia and itch of skin were improved or removed in all cases. Amount of calcium, phosphorus, alkaline phosphatase and intact parathyroid hormone in serum decreased significantly post-operative 3 and 6 months than before (P<0.05). The operation was performed all successful. One case(3.85%) recurred with postoperative complications in 2 cases(7.69%). Conclusions Total parathyroidectomy with forearm autotransplantation would be safe and effective for the treatment of refractory secondary hyperparathyroidism.

Key words: Parathyroid hormone, Hyperparathyroidism, Secondary, Parathyroidectomy, Autotransplantation

CLC Number:

R653

LI Rongguo, ZHANG Weijun, XU Tingyan, DU Qiwei. Total parathyroidectomy with forearm autotransplantation in treatment of secondary hyperparathyroidism[J]. Journal of Surgery Concepts & Practice, 2022, 27(04): 346-350.

Figures/Tables 2

References 19

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时间	血钙 (mmol/L)	血磷 (mmol/L)	血碱性磷酸酶 (U/L)	iPTH (pmol/L)
正常值	2.11~2.52	0.85~1.51	45~125	12~88
术前	2.32±0.32	2.05±0.37	340±317	1 772±800
术后3个月	2.04±0.22	1.00±0.26	212±147	85±320
6个月	1.97±0.37	1.09±0.38	88±43	36±27
F值	6.196	75.500	5.772	83.730
P值	0.003	<0.001	0.005	<0.001

时间	骨痛VAS	瘙痒VAS	睡眠SRSS
术前	7.54±1.83	5.24±2.56	28.53±10.28
术后1个月	4.26±2.85	3.12±1.72	18.31±8.36
t值	6.219	4.219	16.521
P值	<0.05	<0.05	<0.05