Research Information System
Indian Journal of Surgery, vol.84, no.1, pp.94-99, 2022 (SCI-Expanded)
Objectives: Secondary hyperparathyroidism (sHPT) develops as a result of the chronic parathyroid stimulation associated with hypocalcemia, hyperphosphatemia, or vitamin D deficiency and leads to an increase in parathormone (PTH) synthesis and parathyroid cell proliferation in all of the four glands. Background: There are currently three surgical approaches to the treatment of renal hyperparathyroidism: subtotal parathyroidectomy, total parathyroidectomy without autotransplantation, and total parathyroidectomy with autotransplantation. Methods: Included in the study were 79 of which 35 underwent a total parathyroidectomy with autotransplantation (TPTX+AT), while 44 patients underwent a subtotal parathyroidectomy (SPTX). Results: A significant decrease was noted in PTH, calcium, and phosphate levels following both types of parathyroidectomy. It was observed that PTH and phosphate serum levels were controlled significantly better following a total parathyroidectomy with autotransplantation, and the recurrence rate was higher in the subtotal parathyroidectomy group (14.3% vs. 27.3%). Conclusion: Considering its significantly superior outcomes in the short- and long-term, total parathyroidectomy with autotransplantation should be the preferred treatment option in countries where access to kidney transplantation is difficult and where healthcare services are expensive.