Multiglandular Parathyroid Disease: the Results of Surgical Treatment

Background. Sporadic multiple gland disease in primary hyperparathyroidism occurs in 7 to 33 % of cases. The absence of specific risk factors, low sensitivity of imaging methods, and low efficiency of bilateral neck exploration and intraoperative monitoring of parathyroid hormone indicate the comple...

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Autores principales:	E. A. Ilyicheva, G. A. Bersenev, A. V. Zharkaya, D. A. Bulgatov, V. N. Makhutov
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2020
Materias:	sporadic multiple gland disease primary hyperparathyroidism secondary hyperparathyroidism parathyroidectomy persistence of hyperparathyroidism Science Q
Acceso en línea:	https://doaj.org/article/09a56295ebd84b06ae2925921165eab0
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spelling	oai:doaj.org-article:09a56295ebd84b06ae2925921165eab02021-11-23T06:14:44ZMultiglandular Parathyroid Disease: the Results of Surgical Treatment2541-94202587-959610.29413/ABS.2020-5.4.13https://doaj.org/article/09a56295ebd84b06ae2925921165eab02020-09-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/2398https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596Background. Sporadic multiple gland disease in primary hyperparathyroidism occurs in 7 to 33 % of cases. The absence of specific risk factors, low sensitivity of imaging methods, and low efficiency of bilateral neck exploration and intraoperative monitoring of parathyroid hormone indicate the complexity of the diagnosis and treatment of this disease’s form. Aim of the research. To analyze the results of surgical treatment of multiple lesions of the parathyroid gland in primary and secondary hyperparathyroidism. Methods. There was retrospective study, which included 100 observations of surgical treatment for primary and secondary hyperparathyroidism in the thoracic department of Irkutsk Regional Clinical Hospital from May 2018 to September 2019. The main point was to identify the frequency of surgical treatment outcomes in patients with multiple parathyroid lesions. As part of the study, potential predictors of multiple gland disease in primary hyperparathyroidism were analyzed. Results. Multiple gland disease in primary hyperparathyroidism occurs in 29 % of cases and causes persistence of the disease (p ≤ 0.01). Signs of multiple gland disease in primary hyperparathyroidism include the level of ionized calcium, parathyroid hormone (p ≤ 0.05), creatinine level and glomerular filtration rate (p ≤ 0.01). A negative result of intraoperative monitoring correlates with persistence of primary hyperparathyroidism in multiple lesions (χ2, p ≤ 0.05). Selective parathyroidectomy is associated with persistence of hyperparathyroidism in multiple lesions (χ2, p ≤ 0.05), while total parathyroidectomy is associated with remission of the disease (χ2, p ≤ 0.05). We did not find a statistically significant relationship between the results of surgical treatment for morphology of the parathyroid glands (χ2, p > 0.1). Conclusion. Multiple gland disease is the main cause of persistence of primary hyperparathyroidism. This form of the disease corresponds to lower levels of calcium, parathyroid hormone, and kidney function. Persistence factors have been established: removal of less than four parathyroid glands and a negative result of intraoperative monitoring of parathyroid hormone. Bilateral neck exploration does not reduce the incidence of disease persistence.E. A. IlyichevaG. A. BersenevA. V. ZharkayaD. A. BulgatovV. N. MakhutovScientific Сentre for Family Health and Human Reproduction Problemsarticlesporadic multiple gland diseaseprimary hyperparathyroidismsecondary hyperparathyroidismparathyroidectomypersistence of hyperparathyroidismScienceQRUActa Biomedica Scientifica, Vol 5, Iss 4, Pp 90-97 (2020)
institution	DOAJ
collection	DOAJ
language	RU
topic	sporadic multiple gland disease primary hyperparathyroidism secondary hyperparathyroidism parathyroidectomy persistence of hyperparathyroidism Science Q
spellingShingle	sporadic multiple gland disease primary hyperparathyroidism secondary hyperparathyroidism parathyroidectomy persistence of hyperparathyroidism Science Q E. A. Ilyicheva G. A. Bersenev A. V. Zharkaya D. A. Bulgatov V. N. Makhutov Multiglandular Parathyroid Disease: the Results of Surgical Treatment
description	Background. Sporadic multiple gland disease in primary hyperparathyroidism occurs in 7 to 33 % of cases. The absence of specific risk factors, low sensitivity of imaging methods, and low efficiency of bilateral neck exploration and intraoperative monitoring of parathyroid hormone indicate the complexity of the diagnosis and treatment of this disease’s form. Aim of the research. To analyze the results of surgical treatment of multiple lesions of the parathyroid gland in primary and secondary hyperparathyroidism. Methods. There was retrospective study, which included 100 observations of surgical treatment for primary and secondary hyperparathyroidism in the thoracic department of Irkutsk Regional Clinical Hospital from May 2018 to September 2019. The main point was to identify the frequency of surgical treatment outcomes in patients with multiple parathyroid lesions. As part of the study, potential predictors of multiple gland disease in primary hyperparathyroidism were analyzed. Results. Multiple gland disease in primary hyperparathyroidism occurs in 29 % of cases and causes persistence of the disease (p ≤ 0.01). Signs of multiple gland disease in primary hyperparathyroidism include the level of ionized calcium, parathyroid hormone (p ≤ 0.05), creatinine level and glomerular filtration rate (p ≤ 0.01). A negative result of intraoperative monitoring correlates with persistence of primary hyperparathyroidism in multiple lesions (χ2, p ≤ 0.05). Selective parathyroidectomy is associated with persistence of hyperparathyroidism in multiple lesions (χ2, p ≤ 0.05), while total parathyroidectomy is associated with remission of the disease (χ2, p ≤ 0.05). We did not find a statistically significant relationship between the results of surgical treatment for morphology of the parathyroid glands (χ2, p > 0.1). Conclusion. Multiple gland disease is the main cause of persistence of primary hyperparathyroidism. This form of the disease corresponds to lower levels of calcium, parathyroid hormone, and kidney function. Persistence factors have been established: removal of less than four parathyroid glands and a negative result of intraoperative monitoring of parathyroid hormone. Bilateral neck exploration does not reduce the incidence of disease persistence.
format	article
author	E. A. Ilyicheva G. A. Bersenev A. V. Zharkaya D. A. Bulgatov V. N. Makhutov
author_facet	E. A. Ilyicheva G. A. Bersenev A. V. Zharkaya D. A. Bulgatov V. N. Makhutov
author_sort	E. A. Ilyicheva
title	Multiglandular Parathyroid Disease: the Results of Surgical Treatment
title_short	Multiglandular Parathyroid Disease: the Results of Surgical Treatment
title_full	Multiglandular Parathyroid Disease: the Results of Surgical Treatment
title_fullStr	Multiglandular Parathyroid Disease: the Results of Surgical Treatment
title_full_unstemmed	Multiglandular Parathyroid Disease: the Results of Surgical Treatment
title_sort	multiglandular parathyroid disease: the results of surgical treatment
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2020
url	https://doaj.org/article/09a56295ebd84b06ae2925921165eab0
work_keys_str_mv	AT eailyicheva multiglandularparathyroiddiseasetheresultsofsurgicaltreatment AT gabersenev multiglandularparathyroiddiseasetheresultsofsurgicaltreatment AT avzharkaya multiglandularparathyroiddiseasetheresultsofsurgicaltreatment AT dabulgatov multiglandularparathyroiddiseasetheresultsofsurgicaltreatment AT vnmakhutov multiglandularparathyroiddiseasetheresultsofsurgicaltreatment
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Multiglandular Parathyroid Disease: the Results of Surgical Treatment

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