Open Access Research article

Total parathyroidectomy with trace amounts of parathyroid tissue autotransplantation as the treatment of choice for secondary hyperparathyroidism: a single-center experience

Qingqing He1*, Dayong Zhuang1, Luming Zheng1, Ziyi Fan1, Peng Zhou1, Jian Zhu1, Songjian Duan1, Yanning Li1, Yanming Ge2, Zhen Lv1 and Lei Cao1

Author Affiliations

1 Department of Thyroid and Breast Surgery, Jinan Military General Hospital of PLA, No.25 Shifan Road, Jinan 250031, People's Republic of China

2 Blood Purification Center, Jinan Military General Hospital of PLA, Jinan 250031, People's Republic of China

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BMC Surgery 2014, 14:26  doi:10.1186/1471-2482-14-26

Published: 5 May 2014

Abstract

Background

The aim of the study was to evaluate total parathyroidectomy with trace amounts of parathyroid tissue (30 mg) as a surgical option in secondary hyperparathyroidism (sHPT) treatment.

Methods

From January 2008 to March 2012, 47 patients underwent parathyroidectomy. Comparisons of demographic data, symptoms, and preoperative or postoperative biochemistry were made between total parathyroidectomy with trace amounts of parathyroid tissue autotransplantation group and total parathyroidectomy group.

Results

Out of 47 cases, 45 had successful operation. 187 parathyroid glands identified at the initial operation were reported in 47 patients. 43 patients had been diagnosed with parathyroid hyperplasia, and 4 patients had a benign adenoma. After operation, pruritus, bone pain and muscle weakness disappeared, also serum PTH and serum phosphate were declined markedly as well. After discharge, two patients (in total parathyroidectomy group) were readmitted because of postoperative hypoparathyroidism. Graft-dependent recurrence was not observed in an average follow-up of 42 months.

Conclusions

Total parathyroidectomy with sternocleidomastoid muscle trace amounts of parathyroid tissue autotransplantation is considered to be a feasible, safe and effective surgical option for the patients with sHPT.

Keywords:
Secondary hyperparathyroidism; Chronic renal failure; Total parathyroidectomy; Parathyroid hormone; Autotransplantation