Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease
IntroductionSecondary hyperparathyroidism, as a result of chronic kidney disease could be treated medically or surgically. When pharmacotherapy fails, patients undergo surgery - parathyroidectomy, the curative treatment of secondary hyperparathyroidism (SHPT). There are currently 3 accepted surgical...
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1191914/full |
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| author | Cristian Iorga Cristian Iorga Cristina Raluca Iorga Cristina Raluca Iorga Iuliana Andreiana Iuliana Andreiana Iustinian Bengulescu Iustinian Bengulescu Traian Constantin Traian Constantin Victor Strambu Victor Strambu |
| author_facet | Cristian Iorga Cristian Iorga Cristina Raluca Iorga Cristina Raluca Iorga Iuliana Andreiana Iuliana Andreiana Iustinian Bengulescu Iustinian Bengulescu Traian Constantin Traian Constantin Victor Strambu Victor Strambu |
| author_sort | Cristian Iorga |
| collection | DOAJ |
| description | IntroductionSecondary hyperparathyroidism, as a result of chronic kidney disease could be treated medically or surgically. When pharmacotherapy fails, patients undergo surgery - parathyroidectomy, the curative treatment of secondary hyperparathyroidism (SHPT). There are currently 3 accepted surgical techniques, each with supporters or opponents – total parathyroidectomy, subtotal parathyroidectomy and parathyroidectomy with immediate autotransplantation.MethodsIn this paper we described our experience on a series of 160 consecutive patients diagnosed with secondary hyperparathyroidism who underwent surgery, in 27 cases it was totalization of the intervention (patients with previously performed subtotal parathyroidectomy or with supernumerary glands and SHPT recurrence). We routinely perform total parathyroidectomy, the method that we believe offers the best results. ResultsThe group of patients was studied according to demographic criteria, paraclinical balance, clinical symptomatology, pre- and postoperative iPTH (intact parathormone) values, SHPT recurrence, number of reinterventions. In 31 cases we found gland ectopy and in 15 cases we discovered supernumerary parathyroids. A percentage of 96.24% of patients with total parathyroidectomy did not show recurrence.DiscussionsAfter analyzing the obtained results, our conclusion was that total parathyroidectomy is the intervention of choice for patients suffering from secondary hyperparathyroidism when pharmacotherapy fails in order to prevent recurrence of the disease and to correct the metabolic parameters. |
| first_indexed | 2024-03-10T00:03:31Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-10T00:03:31Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-aade5f39d16243349e79537c2ce5cbe62023-11-23T16:13:14ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-11-011410.3389/fendo.2023.11919141191914Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal diseaseCristian Iorga0Cristian Iorga1Cristina Raluca Iorga2Cristina Raluca Iorga3Iuliana Andreiana4Iuliana Andreiana5Iustinian Bengulescu6Iustinian Bengulescu7Traian Constantin8Traian Constantin9Victor Strambu10Victor Strambu11Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaSurgery Clinic, “Dr. Carol Davila” Clinical Nephrology Hospital, Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaSurgery Clinic, “Dr. Carol Davila” Clinical Nephrology Hospital, Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaNephrology Clinic, “Dr. Carol Davila” Clinical Nephrology Hospital, Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaSurgery Clinic, “Dr. Carol Davila” Clinical Nephrology Hospital, Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Urology, “Prof. Dr. Th. Burghele” Hospital, Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaSurgery Clinic, “Dr. Carol Davila” Clinical Nephrology Hospital, Bucharest, RomaniaIntroductionSecondary hyperparathyroidism, as a result of chronic kidney disease could be treated medically or surgically. When pharmacotherapy fails, patients undergo surgery - parathyroidectomy, the curative treatment of secondary hyperparathyroidism (SHPT). There are currently 3 accepted surgical techniques, each with supporters or opponents – total parathyroidectomy, subtotal parathyroidectomy and parathyroidectomy with immediate autotransplantation.MethodsIn this paper we described our experience on a series of 160 consecutive patients diagnosed with secondary hyperparathyroidism who underwent surgery, in 27 cases it was totalization of the intervention (patients with previously performed subtotal parathyroidectomy or with supernumerary glands and SHPT recurrence). We routinely perform total parathyroidectomy, the method that we believe offers the best results. ResultsThe group of patients was studied according to demographic criteria, paraclinical balance, clinical symptomatology, pre- and postoperative iPTH (intact parathormone) values, SHPT recurrence, number of reinterventions. In 31 cases we found gland ectopy and in 15 cases we discovered supernumerary parathyroids. A percentage of 96.24% of patients with total parathyroidectomy did not show recurrence.DiscussionsAfter analyzing the obtained results, our conclusion was that total parathyroidectomy is the intervention of choice for patients suffering from secondary hyperparathyroidism when pharmacotherapy fails in order to prevent recurrence of the disease and to correct the metabolic parameters.https://www.frontiersin.org/articles/10.3389/fendo.2023.1191914/fullsecondary hyperparathyroidismtotal parathyroidectomyparathormonechronic kidney diseasehyperparathyroidism recurrence |
| spellingShingle | Cristian Iorga Cristian Iorga Cristina Raluca Iorga Cristina Raluca Iorga Iuliana Andreiana Iuliana Andreiana Iustinian Bengulescu Iustinian Bengulescu Traian Constantin Traian Constantin Victor Strambu Victor Strambu Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease Frontiers in Endocrinology secondary hyperparathyroidism total parathyroidectomy parathormone chronic kidney disease hyperparathyroidism recurrence |
| title | Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease |
| title_full | Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease |
| title_fullStr | Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease |
| title_full_unstemmed | Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease |
| title_short | Advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease |
| title_sort | advantages of total parathyroidectomy in patients with secondary hyperparathyroidism induced by end stage renal disease |
| topic | secondary hyperparathyroidism total parathyroidectomy parathormone chronic kidney disease hyperparathyroidism recurrence |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1191914/full |
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