Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism
INTRODUCTION: Several methods have been proposed to improve operative success in renal hyperparathyroidism. OBJECTIVE: To evaluate stereomicroscopy in parathyroid tissue selection for total parathyroidectomy with autotransplantation in secondary (SHPT)/tertiary (THPT) hyperparathyroidism. ME...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-07-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942014000400318&lng=en&tlng=en |
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| author | Monique Nakayama Ohe Rodrigo Oliveira Santos Murilo Catafesta das Neves Aluizio Barbosa Carvalho Ilda Sizue Kunii Márcio Abrahão Onivaldo Cervantes Marise Lazaretti-Castro José Gilberto Henriques Vieira |
| author_facet | Monique Nakayama Ohe Rodrigo Oliveira Santos Murilo Catafesta das Neves Aluizio Barbosa Carvalho Ilda Sizue Kunii Márcio Abrahão Onivaldo Cervantes Marise Lazaretti-Castro José Gilberto Henriques Vieira |
| author_sort | Monique Nakayama Ohe |
| collection | DOAJ |
| description | INTRODUCTION: Several methods have been proposed to improve operative success in renal hyperparathyroidism. OBJECTIVE: To evaluate stereomicroscopy in parathyroid tissue selection for total parathyroidectomy with autotransplantation in secondary (SHPT)/tertiary (THPT) hyperparathyroidism. METHODS: 118 renal patients underwent surgery from April of 2000 to October 2009. They were divided into two groups: G1, 66 patients operated from April of 2000 to May of 2005, with tissue selection based on macroscopic observation; G2, 52 patients operated from March of 2008 to October 2009 with stereomicroscopy for tissue selection searching for the presence of adipose cells. All surgeries were performed by the same surgeon. Patients presented SHPT (dialysis treatment) or THPT (renal-grafted). Follow-up was 12-36 months. Intra-operative parathyroid hormone (PTH) was measured in 100/118 (84.7%) patients. RESULTS: Data are presented as means. G1 included 66 patients (38 SHPT, 24 females/14 males; 40.0 years of age; 28 THPT, 14 females/14 males; 44 years of age). G2 included 52 patients (29 SHPT, 11 females/18 males; 50.7 years of age; 23 THPT, 13 females/10 males, 44.4 years of age). SHPT patients from G2 presented preoperative serum calcium higher than those of SHPT patients in G1 (p < 0.05), suggesting a more severe disease. Definitive hypoparathyroidism was found in seven of 118 patients (5.9%). Graft-dependent recurrence occurred in four patients, two in each group. All occurred in dialysis patients. CONCLUSION: Stereomicroscopy in SHPT/THPT surgical treatment may be a useful tool to standardize parathyroid tissue selection. |
| first_indexed | 2024-12-20T10:23:06Z |
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| institution | Directory Open Access Journal |
| issn | 1808-8686 |
| language | English |
| last_indexed | 2024-12-20T10:23:06Z |
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| spelling | doaj.art-26f698afd8dd4dac9fd0161a1b8abcbf2022-12-21T19:43:52ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86862014-07-0180431832410.1016/j.bjorl.2014.05.012S1808-86942014000400318Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidismMonique Nakayama OheRodrigo Oliveira SantosMurilo Catafesta das NevesAluizio Barbosa CarvalhoIlda Sizue KuniiMárcio AbrahãoOnivaldo CervantesMarise Lazaretti-CastroJosé Gilberto Henriques VieiraINTRODUCTION: Several methods have been proposed to improve operative success in renal hyperparathyroidism. OBJECTIVE: To evaluate stereomicroscopy in parathyroid tissue selection for total parathyroidectomy with autotransplantation in secondary (SHPT)/tertiary (THPT) hyperparathyroidism. METHODS: 118 renal patients underwent surgery from April of 2000 to October 2009. They were divided into two groups: G1, 66 patients operated from April of 2000 to May of 2005, with tissue selection based on macroscopic observation; G2, 52 patients operated from March of 2008 to October 2009 with stereomicroscopy for tissue selection searching for the presence of adipose cells. All surgeries were performed by the same surgeon. Patients presented SHPT (dialysis treatment) or THPT (renal-grafted). Follow-up was 12-36 months. Intra-operative parathyroid hormone (PTH) was measured in 100/118 (84.7%) patients. RESULTS: Data are presented as means. G1 included 66 patients (38 SHPT, 24 females/14 males; 40.0 years of age; 28 THPT, 14 females/14 males; 44 years of age). G2 included 52 patients (29 SHPT, 11 females/18 males; 50.7 years of age; 23 THPT, 13 females/10 males, 44.4 years of age). SHPT patients from G2 presented preoperative serum calcium higher than those of SHPT patients in G1 (p < 0.05), suggesting a more severe disease. Definitive hypoparathyroidism was found in seven of 118 patients (5.9%). Graft-dependent recurrence occurred in four patients, two in each group. All occurred in dialysis patients. CONCLUSION: Stereomicroscopy in SHPT/THPT surgical treatment may be a useful tool to standardize parathyroid tissue selection.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942014000400318&lng=en&tlng=enHormônio paratireóideoHiperparatireoidismo secundárioParatireoidectomia |
| spellingShingle | Monique Nakayama Ohe Rodrigo Oliveira Santos Murilo Catafesta das Neves Aluizio Barbosa Carvalho Ilda Sizue Kunii Márcio Abrahão Onivaldo Cervantes Marise Lazaretti-Castro José Gilberto Henriques Vieira Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism Brazilian Journal of Otorhinolaryngology Hormônio paratireóideo Hiperparatireoidismo secundário Paratireoidectomia |
| title | Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism |
| title_full | Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism |
| title_fullStr | Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism |
| title_full_unstemmed | Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism |
| title_short | Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism |
| title_sort | autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism |
| topic | Hormônio paratireóideo Hiperparatireoidismo secundário Paratireoidectomia |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942014000400318&lng=en&tlng=en |
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