title: [Surgical treatment of refractory hyperparathyroidism and usefulness of the intraoperative PTH].
abstract: 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.
authors: Servicio de Otorrinolaringología, Complejo Hospitalario Infanta Cristina, Badajoz, España. vicentepinorivero@terra.com
authors: Vicente
authors: V
authors: Pino Rivero
authors: Alicia
authors: A
authors: González Palomino
authors: Carlos G
authors: CG
authors: Pantoja Hernández
authors: María Elena
authors: ME
authors: Mora Santos
authors: Mercedes
authors: M
authors: Guerra Camacho
authors: Fernando
authors: F
authors: Carrasco Claver
authors: Gonzalo
authors: G
authors: Barrantes Celaya
mesh_terms: 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
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium