Korean J Otorhinolaryngol-Head Neck Surg.
2013 Mar;56(3):149-153. 10.3342/kjorl-hns.2013.56.3.149.
Efficacy of Subtotal Parathyroidectomy in Secondary Renal Hyperparathyroidism: Long-Term Follow-Up Result
- Affiliations
-
- 1Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea. kytae@hanyang.ac.kr
- 2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
- KMID: 2277874
- DOI: http://doi.org/10.3342/kjorl-hns.2013.56.3.149
Abstract
- BACKGROUND AND OBJECTIVES
Most secondary hyperparathyroidism is caused by chronic kidney disease. The purpose of this study is to evaluate the effectiveness of subtotal parathyroidectomy in the surgical treatment of renal hyperparathyroidism.
SUBJECTS AND METHOD
We studied twelve patients with renal hyperparathyroidism who underwent parathyroidectomy from Dec. 2002 to Mar. 2007. We measured the amount of serum, intact parathyroid hormone, calcium, ionized calcium, inorganic phosphorus, and alkaline phosphatase preoperatively and postoperatively.
RESULTS
Subtotal parathyroidectomy was performed in nine patients, and three enlarged parathyroid glands were removed from three patients. Hyperparathyroidism was observed in four patients (33.3%), normal parathyroid function in six patients (50.0%) and hypoparathyroidism in two patients (16.7%) at 5 years after surgery. All of three patients who had removed three enlarged parathyroid glands showed persistent hyperparathyroidism. Serum ionized calcium was normal in 10 patients and two patients showed hypocalcemia after operation.
CONCLUSION
Based on the results of this study, we conclude that subtotal parathyroidectomy may be effective in the surgical treatment of renal hyperparathyroidism. However, further studies are necessary to determine the optimal amount of remnant parathyroid tissue in subtotal parathyroidectomy to maintain normal parathyroid function postoperatively.
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