[Surgical treatment of refractory hyperparathyroidism and usefulness of the intraoperative PTH].
OBJECTIVE
To share our experience in the surgery of so-called refractory hyperparathyroidism (secondary and tertiary without response to therapy with calcitriol).


METHODS
Retrospective study based on 41 patients-5 with secondary and 6 with tertiary hyperparathyroidism-referred by nephrology for surgical evaluation of their illness because of poor response to the medical treatment given.


RESULTS
In 18 of the 41 cases we used the fast or turbo intra-operative PTH with reduction of more than 60 % in all patients. In the group in whom normal PTH was performed, we registered 2 secondary hyperparathyroidisms with no significant decrease and persistence of symptoms. One of them was reoperated successfully.


CONCLUSIONS
Subtotal or total parathyroidectomy with reimplant represents the treatment of choice in refractory hyperparathyroidism with good results in most of the series reviewed.
Pino Rivero
Vicente
V
Servicio de Otorrinolaringología, Complejo Hospitalario Infanta Cristina, Badajoz, España. vicentepinorivero@terra.com
González Palomino
Alicia
A
Pantoja Hernández
Carlos G
CG
Mora Santos
María Elena
ME
Guerra Camacho
Mercedes
M
Carrasco Claver
Fernando
F
Barrantes Celaya
Gonzalo
G
D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood* / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy / Q000379:methods*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
D010281:Parathyroid Hormone; D002118:Calcium