Conservative three-quarter versus subtotal seven-eighths parathyroidectomy in secondary hyperparathyroidism - Sorbonne Université Accéder directement au contenu
Article Dans Une Revue European Annals of Otorhinolaryngology, Head and Neck Diseases Année : 2019

Conservative three-quarter versus subtotal seven-eighths parathyroidectomy in secondary hyperparathyroidism

Résumé

OBJECTIVE: There is at present no consensus concerning surgical techniques for secondary hyperparathyroidism (SHPT) in end-stage renal disease (ESRD). Although both subtotal and total parathyroidectomy provide low rates of recurrence, they may induce hypoparathyroidism, damaging the bone and cardiovascular systems. The aim of our study was to compare 3/4 and 7/8 parathyroidectomy in this population and to discuss the potential benefit of more conservative treatment. STUDY DESIGN: Prospective observational study in a university teaching hospital between 2010 and 2014. METHODS: The study included 34 consecutive ESRD patients with SHPT: 19 underwent 3/4 parathyroidectomy (group A*3/4) and 15 underwent 7/8 parathyroidectomy (group B*7/8). Serum intact 1-84 PTH levels (before and 6 months after surgery) and hospital stay were compared between the two groups. RESULTS: Before surgery, PTH levels were similar between the two groups. At month 6 following surgery, median PTH levels were significantly higher in group A*3/4 than in group B*7/8 (109 versus 24pg/mL, respectively; P<0.0006). Hospital stay was shorter in group A*3/4 (4.79 versus 6.80 days, respectively; P=0.008). Postoperative hypoparathyroidism requiring long-term calcium and 1alpha(OH) D3 treatment was reported in 5% of patients in group A*3/4 and 26% of patients in group B*7/8 (P=0.04). CONCLUSIONS: In this preliminary study, 3/4 conservative parathyroidectomy seemed effective and safe, with less reported morbidity than 7/8 parathyroidectomy, as assessed by lower rates of irreversible hypoparathyroidism and shorter hospital stay.
Fichier principal
Vignette du fichier
1-s2.0-S1879729618301510-main_sans marque.pdf (445.55 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Loading...

Dates et versions

hal-02271833 , version 1 (27-08-2019)

Identifiants

Citer

M. Veyrat, H. Fessi, J.-P. Haymann, P. Ronco, J. Lacau St Guily, et al.. Conservative three-quarter versus subtotal seven-eighths parathyroidectomy in secondary hyperparathyroidism. European Annals of Otorhinolaryngology, Head and Neck Diseases, 2019, 136 (2), pp.63-68. ⟨10.1016/j.anorl.2018.09.003⟩. ⟨hal-02271833⟩
40 Consultations
98 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More