title: Short-term efficacy of surgical treatment of secondary hyperparathyroidism.
abstract: OBJECTIVE
  We wished to explore short-term efficacy of surgical treatment of secondary hyperparathyroidism in patients with the end-stage renal disease. The treatment methods were subtotal or total parathyroidectomy, or total parathyroidectomy and autotransplantation.
  
  
  METHODS
  63 patients with secondary hyperparathyroidism were randomly divided into three groups which were respectively treated with subtotal parathyroidectomy (SPTX group), total parathyroidectomy (TPTX group), or total parathyroidectomy and autotransplantation (TPTX+AT group). The surgical outcomes included operating time, transoperative bleeding volume, length of stay, and cost of hospitalization. In addition, complication (e.g., postoperative wound infection, hematoma, hypocalcemia in perioperative period) rates were compared among groups. Blood levels of calcium and parathyroid hormone were assessed before the surgery, and 1 day, 1 months, 3 months and 6 months after the surgery. The follow-up period comprised 6 months.
  
  
  RESULTS
  Surgical outcomes were the lowest in SPTX group and the highest in in TPTX+AT group. There were no significant differences among groups in treatment efficacy. Complication rates were also comparable among the three groups. The occurrence of hypocalcemia was the lowest in SPTX group (p < 0.05 vs. other groups). However, postoperative relapse rate was the highest in this group (p < 0.05 vs. other groups). There were no correlations between the levels of blood calcium and PTH preoperatively and postoperatively.
  
  
  CONCLUSIONS
  Appropriate surgical treatment is selected in accordance with the patient's condition and willingness, with the attention paid to the prevention of hypocalcemia.
authors.affiliation: Breast and Thyroid Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. zhangfan316@medmail.com.cn.
authors.forename: Y
authors.initials: Y
authors.lastname: Liang
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.forename: L
authors.initials: L
authors.lastname: Ren
authors.forename: X-W
authors.initials: XW
authors.lastname: Qi
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: F
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods* / Q000639:trends; D012008:Recurrence; D013997:Time Factors; D014182:Transplantation, Autologous / Q000379:methods / Q000639:trends; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium