Experience of surgical treatment of secondary hyperparathyroidism

Surgical treatment of secondary hyperparathyroidism (HPT) in patients having renal replacement therapy (RRT) is a current problem. The aim of our study was to optimize the treatment of secondary HPT based on the comparative analysis of effectiveness of the surgeries with different extents. We conduc...

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Autores principales:	E. A. Ilyicheva, A. V. Zharkaya, V. N. Makhutov, E. V. Rozhanskaya, D. A. Bulgatov, S. A. Papeshina
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2016
Materias:	secondary hyperparathyroidism parathyroidectomy Science Q
Acceso en línea:	https://doaj.org/article/8ad9933195114bd3b42900e3b519e55c
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spelling	oai:doaj.org-article:8ad9933195114bd3b42900e3b519e55c2021-11-23T06:14:35ZExperience of surgical treatment of secondary hyperparathyroidism2541-94202587-959610.12737/22938https://doaj.org/article/8ad9933195114bd3b42900e3b519e55c2016-07-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/237https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596Surgical treatment of secondary hyperparathyroidism (HPT) in patients having renal replacement therapy (RRT) is a current problem. The aim of our study was to optimize the treatment of secondary HPT based on the comparative analysis of effectiveness of the surgeries with different extents. We conducted a retrospective analysis of the results of surgical treatment of uremic HPT in 34 patients. 36 surgeries were performed including 34 primary (16 subtotal parathyroidecomies (PTE), 13 total parathyroidecomies (total PTE 1), 5 total parathyroidecomies with central neck dissection and resection of superior mediastinum and superior thymus horns (total PTE II)) and 2 repeated surgeries (total PTE 11 and parathyroidadenomectomy). Gross examination of 134 surgical specimens revealed dyssynchronous pathological changes in parathyroid glands (PTG), normal PTG structure was found in 2 cases. Recurrent HPT was found in 3 cases, persistent HPT - in 9 cases, hypoparathyroidism - in 5 cases after subtotal PTE and in 9 cases after total PTE with autotransplantation (p = 0,267). Target values of parathyroid hormone were registered in 8 patients, including 4 patients after subtotal PTE and 4 patients after total PTE (p > 0,95). Morbidity was similar in all types of surgeries (p > 0,5). Analysis of morbidity determined that simultaneous surgery of thyroid gland increased the risk of laryngeal paralysis (р = 0,028). The decrease in occurrence of secondary HPT persistence (with the source accessible for removal through cervical approach) at total PTE based on the removal of parathyroid glands of all localizations accessible through cervical approach (including thyroid gland lobes with diagnosed ectopia, central cervical fat pad, superior mediastinum and superior thymus horns) was registered (NNT = 4).E. A. IlyichevaA. V. ZharkayaV. N. MakhutovE. V. RozhanskayaD. A. BulgatovS. A. PapeshinaScientific Сentre for Family Health and Human Reproduction Problemsarticlesecondary hyperparathyroidismparathyroidectomyScienceQRUActa Biomedica Scientifica, Vol 1, Iss 4, Pp 29-35 (2016)
institution	DOAJ
collection	DOAJ
language	RU
topic	secondary hyperparathyroidism parathyroidectomy Science Q
spellingShingle	secondary hyperparathyroidism parathyroidectomy Science Q E. A. Ilyicheva A. V. Zharkaya V. N. Makhutov E. V. Rozhanskaya D. A. Bulgatov S. A. Papeshina Experience of surgical treatment of secondary hyperparathyroidism
description	Surgical treatment of secondary hyperparathyroidism (HPT) in patients having renal replacement therapy (RRT) is a current problem. The aim of our study was to optimize the treatment of secondary HPT based on the comparative analysis of effectiveness of the surgeries with different extents. We conducted a retrospective analysis of the results of surgical treatment of uremic HPT in 34 patients. 36 surgeries were performed including 34 primary (16 subtotal parathyroidecomies (PTE), 13 total parathyroidecomies (total PTE 1), 5 total parathyroidecomies with central neck dissection and resection of superior mediastinum and superior thymus horns (total PTE II)) and 2 repeated surgeries (total PTE 11 and parathyroidadenomectomy). Gross examination of 134 surgical specimens revealed dyssynchronous pathological changes in parathyroid glands (PTG), normal PTG structure was found in 2 cases. Recurrent HPT was found in 3 cases, persistent HPT - in 9 cases, hypoparathyroidism - in 5 cases after subtotal PTE and in 9 cases after total PTE with autotransplantation (p = 0,267). Target values of parathyroid hormone were registered in 8 patients, including 4 patients after subtotal PTE and 4 patients after total PTE (p > 0,95). Morbidity was similar in all types of surgeries (p > 0,5). Analysis of morbidity determined that simultaneous surgery of thyroid gland increased the risk of laryngeal paralysis (р = 0,028). The decrease in occurrence of secondary HPT persistence (with the source accessible for removal through cervical approach) at total PTE based on the removal of parathyroid glands of all localizations accessible through cervical approach (including thyroid gland lobes with diagnosed ectopia, central cervical fat pad, superior mediastinum and superior thymus horns) was registered (NNT = 4).
format	article
author	E. A. Ilyicheva A. V. Zharkaya V. N. Makhutov E. V. Rozhanskaya D. A. Bulgatov S. A. Papeshina
author_facet	E. A. Ilyicheva A. V. Zharkaya V. N. Makhutov E. V. Rozhanskaya D. A. Bulgatov S. A. Papeshina
author_sort	E. A. Ilyicheva
title	Experience of surgical treatment of secondary hyperparathyroidism
title_short	Experience of surgical treatment of secondary hyperparathyroidism
title_full	Experience of surgical treatment of secondary hyperparathyroidism
title_fullStr	Experience of surgical treatment of secondary hyperparathyroidism
title_full_unstemmed	Experience of surgical treatment of secondary hyperparathyroidism
title_sort	experience of surgical treatment of secondary hyperparathyroidism
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2016
url	https://doaj.org/article/8ad9933195114bd3b42900e3b519e55c
work_keys_str_mv	AT eailyicheva experienceofsurgicaltreatmentofsecondaryhyperparathyroidism AT avzharkaya experienceofsurgicaltreatmentofsecondaryhyperparathyroidism AT vnmakhutov experienceofsurgicaltreatmentofsecondaryhyperparathyroidism AT evrozhanskaya experienceofsurgicaltreatmentofsecondaryhyperparathyroidism AT dabulgatov experienceofsurgicaltreatmentofsecondaryhyperparathyroidism AT sapapeshina experienceofsurgicaltreatmentofsecondaryhyperparathyroidism
_version_	1718417020690628608

Experience of surgical treatment of secondary hyperparathyroidism

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