Surgical management of secondary hyperparathyroidism: how to effectively reduce recurrence at the time of primary surgery.

Abstract:

BACKGROUND:Successful parathyroidectomy (PTX) often results in a dramatic drop in the parathyroid hormone (PTH) levels, relieves the patient from clinical symptoms, and reduces mortality. Although PTX is generally a successful treatment for progressive secondary hyperparathyroidism (SHPT) patients subjected to surgery, a significant proportion develops recurrent SHPT following PTX. KEY MESSAGE:SHPT requiring PTX occurs more commonly in progressive chronic kidney disease and in long-term lithium therapy. Operative approaches include subtotal PTX, total PTX with or without autotransplantation, and possible thymectomy. Each approach has its proponents, advantages, and disadvantages. Although PTX offers the highest percentage cure for SHPT, compared to all other medical and surgical treatment, recurrent hyperparathyroidism can be observed in some patients dependent on follow-up time. A literature review and analysis of recent data regarding how to reduce recurrence of SHPT at the time of primary surgery was performed. The current literature and our own experience in the field have confirmed that pre-operative imaging, thymectomy, stereo magnifier, and surgical procedure may effectively reduce recurrence of SHPT at the time of primary surgery.

journal_name

J Endocrinol Invest

authors

Xu D,Yin Y,Hou L,Dai W

doi

10.1007/s40618-015-0410-8

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

509-14

issue

5

eissn

0391-4097

issn

1720-8386

pii

10.1007/s40618-015-0410-8

journal_volume

39

pub_type

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