1. bookVolumen 22 (2014): Edición 3 (September 2014)
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eISSN
2284-5623
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08 Aug 2013
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4 veces al año
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Parathyroidectomy in the treatment of secondary hyperparathyroidism. Clinical and laboratory outcomes/ Paratiroidectomia în tratamentul hiperparatiroidismului secundar. Aspecte clinice şi de laborator

Publicado en línea: 08 Oct 2014
Volumen & Edición: Volumen 22 (2014) - Edición 3 (September 2014)
Páginas: 355 - 367
Recibido: 02 Jan 2014
Aceptado: 22 Jul 2014
Detalles de la revista
License
Formato
Revista
eISSN
2284-5623
Primera edición
08 Aug 2013
Calendario de la edición
4 veces al año
Idiomas
Inglés
Abstract

Background. Secondary hyperparathyroidism (sHPT) is frequently encountered in patients on hemodialysis (HD) for end stage renal disease (ESRD). In spite of improved medical therapy, parathyroidectomy is still frequentely indicated for patients with medically refractory secondary and tertiary hyperparathyroidism. The aim of this study is to analyse the impact of parathyroidectomy, regardless of the surgical procedure, on perioperative and follow-up clinical symptoms and biochemistry tests. Material and method. We studied 29 patients who underwent parathyroidectomy for sHPT due to ESRD, at the Second Department of Surgery, Emergency Mures County Hospital, between February 2010 and May 2013. Outcome parameters included symptoms relieving (bone pains, pruritus, etc) and laboratory data (intact parathyroid hormone (iPth), total calcium and phosphorus, serum alkaline phosphatase (AlkPhos), hematocrit and hemoglobin), assesed before, shortly after and then at short-medium term follow-up. Results. The majority of our patients had significant improvement of the symptoms during the follow-up period. The iPTH values considerably decreased after the operation. The postoperative calcemia mean value decreased and we have identified statistically significant differences between the monthly calcemia average values (p-0.008). The mean phosphorus level in the first 2 postoperative months decreased significantly (p-0.001) and we recorded statistically significant decreases (p-0.0007) in AlkPhos level after the operation. Both hematocit and hemoglobin levels experienced a statistical significant growth in the follow-up period. Persistent HPT was encountered in two patients (6.89%), and we had 8 patients who developed mild hypocalcaemia in the first month after the operation (“hungry bones” syndrome). We had few minor and transient postoperative complications and we did not encountered postoperative mortality in our series. Conclusions. Parathyroidectomy, regardless of the technical procedure, is feasible, safe and effective for patients with refractory secondary and tertiary hyperparathyroidism.

Keywords

Cuvinte cheie

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