[Subtotal parathyroidectomy versus total parathyroidectomy with autotransplantation in secondary hyperparathyroidism. A randomized study].
In this randomised study subtotal parathyroidectomy (PTX) is being compared with total parathyroidectomy including autotransplantation (PTX + AT) in 40 patients with secondary hyperparathyroidism. Both groups were followed up twice, first 19 +/- 6 months (PTX + AT) respectively 19 +/- 7 months (subtotal PTX) and secondly 43 +/- 9 respectively 40 +/- 7 months after surgery. In each group there were 17 patients alive at the time of the second postoperative follow-up. In the meantime 2 patients with subtotal PTX required reoperation because of recurrences originating from the remaining parathyroid tissue, another 2 patients of this group were hypercalcaemic. After PTX + AT serum-calcium normalized significantly more often (p less than 0.03), a corresponding result was seen in alkaline phosphatase. Reoperation was not required in this group. Also radiological alterations reformed significantly more often after PTX + AT, so did clinical signs like pruritus (p less than 0.005) and muscular weakness (p less than 0.04). Considering these results and the fact that in case of recidive a reoperation of the autograft in the forearm is much easier to perform than a reoperation in the neck, PTX + AT is recommended as method of choice in surgical treatment of sHPT.
Wagner
P K
PK
Klinik für Allgemeinchirurgie, Philipps-Universität Marburg/Lahn.
Eckhardt
J
J
Rothmund
M
M
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000637:transplantation*; D016105:Parathyroidectomy / Q000379:methods*; D012008:Recurrence; D012086:Reoperation
Subtotale Parathyreoidektomie versus totale Parathyreoidektomie mit Autotransplantation beim sekundären Hyperparathyreoidismus. Eine randomisierte Studie.