title: Subtotal parathyroidectomy versus total parathyroidectomy  with autotransplant in secondary hyperparathyroidism  — a single-centre prospective cohort of 43 patients.
abstract: BACKGROUND
  The need for parathyroidectomy remains high in the group of patients on long-term dialysis with medically refractory secondary hyperparathyroidism (sHPT). We aim to compare the results after subtotal parathyroidectomies (sPtx) and total parathyroidectomies with autotransplant (tPtx + AT) performed for sHPT at a single referral centre.
  
  
  METHODS
  This prospective study comparatively analysed sPtx and tPtx + AT performed in our department between February 2010 and December 2014. We followed-up both surgical techniques, with respect to the main clinical symptoms, laboratory data, mortality, and recurrent disease.
  
  
  RESULTS
  Forty-three patients on whom we performed 26 sPtx and 19 tPtx + AT were entered in the study. There were no statistically significant differences between groups as far as demographic and preoperative clinical data are concerned. We did not encounter postoperative mortality in either of the groups. The follow-up period was significantly longer for the sPtx group (p = 0.04). The immediate postoperative serum calcium levels were significantly lower in the tPtx + AT group (p = 0.009). Definitive hypoparathyroidism was encountered in two patients in the sPtx group (8.3%) and in one from the tPtx + AT group (5.26%). Four patients from the sPtx group (16.6%) and three from the tPtx + AT group (15.78%) died during the follow-up due to causes unrelated to parathyroidectomy. Overall we had two recurrences in the sPtx group and none in the tPtx + AT group (p = 0.57).
  
  
  CONCLUSIONS
  In our opinion both techniques have comparable results concerning the clinical and laboratory outcomes and rates of postoperative hypoparathyroidism, at least in short- and medium-term follow-up.
authors.forename: Radu Mircea
authors.initials: RM
authors.lastname: Neagoe
authors.forename: Mircea
authors.initials: M
authors.lastname: Mureșan
authors.forename: Septimiu
authors.initials: S
authors.lastname: Voidăzan
authors.forename: Ionela
authors.initials: I
authors.lastname: Pașcanu
authors.forename: Cristina Pop
authors.initials: CP
authors.lastname: Radu
authors.forename: Daniela Tatiana
authors.initials: DT
authors.lastname: Sala
mesh_terms: D000328:Adult; D064592:Autografts; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome