Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?

Seventy-six patients underwent parathyroidectomy for renal hyperparathyroidism. There were 10 subtotal parathyroidectomies, 49 total parathyroidectomies with implantation of part of one gland as an autograft, nine total parathyroidectomies with no autograft, and eight patients in whom only three par...

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Main Authors: Higgins, R, Richardson, A, Ratcliffe, P, Woods, C, Oliver, DO, Morris, P
Format: Journal article
Language:English
Published: 1991
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author Higgins, R
Richardson, A
Ratcliffe, P
Woods, C
Oliver, DO
Morris, P
author_facet Higgins, R
Richardson, A
Ratcliffe, P
Woods, C
Oliver, DO
Morris, P
author_sort Higgins, R
collection OXFORD
description Seventy-six patients underwent parathyroidectomy for renal hyperparathyroidism. There were 10 subtotal parathyroidectomies, 49 total parathyroidectomies with implantation of part of one gland as an autograft, nine total parathyroidectomies with no autograft, and eight patients in whom only three parathyroid glands were found. In 34 dialysis patients who underwent total parathyroidectomy with an autograft there was a high rate of recurrent hyperparathyroidism after 6 years in those remaining on dialysis. Fifty per cent had asymptomatic recurrent hyperparathyroidism and 30 per cent required partial autograft excision for symptomatic hyperparathyroidism. In contrast, recurrent hyperparathyroidism was rare in renal transplant recipients with good renal function. This favourable outcome did not depend upon whether parathyroid surgery was performed before or after transplantation, or on the type of parathyroidectomy. Total parathyroidectomy without an autograft was performed in nine dialysis patients without any short-term adverse effects, and with clinical and pathological improvement in bone disease. In summary, the results of surgery for renal hyperparathyroidism were excellent in patients who received a successful renal transplant. However, there was a high incidence of recurrent hyperparathyroidism in patients who remained on long-term dialysis. Total parathyroidectomy without an autograft may be the treatment of choice in patients unlikely to receive a renal transplant.
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spelling oxford-uuid:2bf52e38-95dc-4f53-b117-5ba64e440fdd2022-03-26T12:34:03ZTotal parathyroidectomy alone or with autograft for renal hyperparathyroidism?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:2bf52e38-95dc-4f53-b117-5ba64e440fddEnglishSymplectic Elements at Oxford1991Higgins, RRichardson, ARatcliffe, PWoods, COliver, DOMorris, PSeventy-six patients underwent parathyroidectomy for renal hyperparathyroidism. There were 10 subtotal parathyroidectomies, 49 total parathyroidectomies with implantation of part of one gland as an autograft, nine total parathyroidectomies with no autograft, and eight patients in whom only three parathyroid glands were found. In 34 dialysis patients who underwent total parathyroidectomy with an autograft there was a high rate of recurrent hyperparathyroidism after 6 years in those remaining on dialysis. Fifty per cent had asymptomatic recurrent hyperparathyroidism and 30 per cent required partial autograft excision for symptomatic hyperparathyroidism. In contrast, recurrent hyperparathyroidism was rare in renal transplant recipients with good renal function. This favourable outcome did not depend upon whether parathyroid surgery was performed before or after transplantation, or on the type of parathyroidectomy. Total parathyroidectomy without an autograft was performed in nine dialysis patients without any short-term adverse effects, and with clinical and pathological improvement in bone disease. In summary, the results of surgery for renal hyperparathyroidism were excellent in patients who received a successful renal transplant. However, there was a high incidence of recurrent hyperparathyroidism in patients who remained on long-term dialysis. Total parathyroidectomy without an autograft may be the treatment of choice in patients unlikely to receive a renal transplant.
spellingShingle Higgins, R
Richardson, A
Ratcliffe, P
Woods, C
Oliver, DO
Morris, P
Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?
title Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?
title_full Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?
title_fullStr Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?
title_full_unstemmed Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?
title_short Total parathyroidectomy alone or with autograft for renal hyperparathyroidism?
title_sort total parathyroidectomy alone or with autograft for renal hyperparathyroidism
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AT richardsona totalparathyroidectomyaloneorwithautograftforrenalhyperparathyroidism
AT ratcliffep totalparathyroidectomyaloneorwithautograftforrenalhyperparathyroidism
AT woodsc totalparathyroidectomyaloneorwithautograftforrenalhyperparathyroidism
AT oliverdo totalparathyroidectomyaloneorwithautograftforrenalhyperparathyroidism
AT morrisp totalparathyroidectomyaloneorwithautograftforrenalhyperparathyroidism