Effects of total parathyroidectomy with improved autotransplantation on hyperthyroidism secondary to uremia

doi:10.3969/j.issn.1674-3806.2019.01.09

Abstract：Objective To investigate the effects of total parathyroidectomy with improved autotransplantation (TPTX+AT) of 5 autologous parathyroid tissue pieces (each one 1 mm×1 mm×1 mm) on secondary hyperparathyroidism (SHPT) to uremia.Methods The patients with SHPT to uremia were selected from January 2016 to December 2017, and 5 autologous parathyroid tissue pieces (each one 1 mm×1 mm×1 mm) were transplanted into the patients'healthy forearms after total parathyroid thyroidectomy.The serum levels of total parathyroid hormone (i PTH), serum calcium and phosphorus, relief of symptoms of SHPT, operative complications, postoperative hospitalization time and postoperative recurrence rate were observed.Results Thirteen patients underwent this procedure (TPTX+AT).All the patients had no intraoperative laryngeal nerve injury.On the first day after operation, i PTH was reduced to normal level in all the patients.At 1 week, 3 months, 6 months and 12 months after operation, the serum i PTHs were significantly decreased compared with those before operation (P＜0.05).And all these postoperative indicators were within the normal ranges, with no recurrence cases.The symptoms of bone pain and pruritus were relieved or disappeared within one week, and the symptoms of bone deformation and height shortening were improved or did not progress.Conclusion TPTX+AT is a safe, effective and better method for the treatment of SHPT to uremia.It can preserve the parathyroid function and control the postoperative recurrence of hyperparathyroidism.