Success Rate and Factors Related to Surgical Treatment in Secondary and Tertiary Hyperparathyroidism in Chronic Renal Failure and the Accuracy of Preoperative Localization
Keywords:Secondary hyperparathyroidism, Tertiary hyperparathyroidism, Persistent hyperparathyroidism, Recurrent hyperparathyroidism, Preoperative localization, setamibi, ultrasound
Number of hyperparathyroidism (HPT) in chronic renal failure is increasing. Surgical treatment is required when medical treatment failed. There are variations of measurement, operations and outcomes. This study aimed to assess success rate, factors related to success of surgical treatment in secondary and tertiary HPT in chronic renal failureand the accuracy of preoperative localization of parathyroid gland in Rajavithi hospital. A cross-sectional retrospective study in 173 patients operated for total parathyroidectomy with autoimplanted between 2011 and 2017 was conducted. Ninety were female (52%), 83 were male (48%), 74 were diagnosed for secondary HPT (42.8%), and 99 were diagnosed for tertiary HPT (57.2). Success rate of operation was 88.4%. Significant factors were numbers of removable glands, age of patients and reduction of parathyroid hormone in first day post operation compared with preoperative level. None significant factors are sex and serum calcium level in pre and post operation period. The findings gave high success rate. However, the accuracy of preoperative localization is low, setamibi 16.6%; ultrasound 14.6% and combined 19.6%.
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