World Journal of Endocrine Surgery

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VOLUME 3 , ISSUE 3 ( September-December, 2011 ) > List of Articles

RESEARCH ARTICLE

The Efficiency of Parathyroidectomy and the Comparison of the Complications of Surgical Procedures in Dialysis Patients

Çağlayan Kasım, Bülent Güngör, Bülent Koca, Hamza Çınar, Zafer Malazgirt, Cafer Polat, Kenan Erzurumlu

Citation Information : Kasım Ç, Güngör B, Koca B, Çınar H, Malazgirt Z, Polat C, Erzurumlu K. The Efficiency of Parathyroidectomy and the Comparison of the Complications of Surgical Procedures in Dialysis Patients. World J Endoc Surg 2011; 3 (3):103-106.

DOI: 10.5005/jp-journals-10002-1069

Published Online: 01-08-2014

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

Secondary hyperparathyroidism is the hyperplasia and hyperfunctioning of the parathyroid gland in chronic renal failure. The aim of our study was to evaluate the efficiency and complications of surgical methods for secondary hyperparathyroidism in patients requiring dialysis. Forty-one patients operated for secondary hyperparathyroidism before renal transplantation were retrospectively analysed. The efficiency and complications of types of surgery in relation with age, gender, duration of dialysis, symptoms, laboratory test results before and after surgery were evaluated. Mean duration of dialysis was 6.2 ± 3.98 years. Patient's calcium, phosphorus and parathormone levels before surgery were 9.83 ± 1.25 mg/dl, 5.73 ± 2.15 mg/dl, 1847, 0.02 ± 666.602 pg/ml and, after surgery, were 7.85 ± 1.36 mg/dl, 4.5 ± 1.55 mg/dl, 288.05 ± 404.09 pg/ml. The differences betweeen preoperative and postoperative values were statistically significant (p < 0.05) recognizing the efficiency of surgery. The age of patients, the duration of dialysis and the type of surgery were not significantly effective on this difference (p > 0.05). Fifteen patients had subtotal parathyroidectomy, 25 patients had total parathyroidectomy with autotransplantation and one patient had total parathyroidectomy. The incidence of complications did not differ with age, gender, duration of dialysis and type of surgery (p > 0.05). The type of surgery did not possess difference in the improvement in levels of calcium, phosphorus and parathormone and also in the incidence of complications in secondary hyperparathyroidism. Surgeon's experience and individual patient characteristics seem to be more important in determining the type of surgery.


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  1. Management of secondary hyperparathyroidism: The importance and the challenge of controlling parathyroid hormone levels without elevating calcium, phosphorus, and calcium-phosphorus product. Am J Nephrol 2003;23(6):369-79.
  2. Hyperparathyroidism. Lancet 2009;374:145-58.
  3. Gender differences among patients with secondary hyperparathyroidism undergoing parathyroidectomy. Journal of Surgical Research 2009;1-6.
  4. Total parathyroidectomy without autotransplantation for the treatment of secondary hyperparathyroidism associated with chronic kidney disease: Clinical and laboratory long-term follow-up. Biomedicine and Pharmacotherapy 2010;64(5):359-62.
  5. Surgical indications and procedures of parathyroidectomy in patients with chronic kidney disease. Therapeutic Apheresis and Dialysis 2005;9(1):44-47.
  6. Surgical treatment of secondary hyperparathyroidism. Dialog in Endocrinology 2010;7(4): 156-61.
  7. Renal hyperparathyroidism: Current therapeutic approaches and future directions. Operative Techniques in Otolaryngology 2009;20(1):71-78.
  8. Laboratory screening for hyperparathyroidism. Clinica Chimica Acta 2005;353(1-2):1-12.
  9. Secondary hyperparathyroidism: Review of the disease and its treatment. Clin Ther 2004;26(12):1976-93.
  10. Survival following parathyroidectomy among United States dialysis patients. Kidney Int 2004;66(5):2010-16.
  11. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract 2008;14(1):18-27.
  12. Total parathyroidectomy without autotransplantation for renal hyperparathyroidism: Experience with a qPTHcontrolled protocol. World J Surg 2006;30(5):743-51.
  13. Effectiveness of surgical parathyroidectomy for secondary hyperparathyroidism in renal dialysis patients in Qatar. Transplant Proc 2004;36(6):1815-17.
  14. Parathyroidectomy in secondary hyperparathyroidism: Is there an optimal operative management? Surgery 2006;139(2):174-80.
  15. Secondary Hyperparathyroidism: Pathophysiology and treatment. J Am Board Fam Med 2009; 22(5):574-81.
  16. Total parathyroidectomy without autotransplantation as a standard procedure in the treatment of secondary hyperparathyroidism. Langenbeck's Arch Surg 2002;387(5-6):204-09.
  17. Total parathyroidectomy without autotransplantation in dialysis patients and renal transplant recipients, long-term follow-up evaluation. Am J Surg 2009;198(2):173-83.
  18. Predictors of early postoperative hypocalcemia in hemodialysis patients with secondary hyperparathyroidism. Transplant Proc 2009;41(9):3642-46.
  19. Post-parathyroidectomy hypocalcemia: Incidence, risk factors, and management. Am Surg 2004;70(2):114-19; discussion 119-20.
  20. Predictive value of age and serum parathormone and vitamin D3 levels for postoperative hypocalcemia after total thyroidectomy for nontoxic multinodular goiter. Arch Surg 2007;142(12):1182-87.
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