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Total Parathyroidectomy and Autotransplantation by the Subcutaneous Injection Technique in Secondary Hyperparathyroidism

Authors
 Jong Ho Yoon  ;  Kee-Hyun Nam  ;  Hang-Seok Chang  ;  Woong Youn Chung  ;  Cheong Soo Park 
Citation
 SURGERY TODAY, Vol.36(4) : 304-307, 2006 
Journal Title
SURGERY TODAY
ISSN
 0941-1291 
Issue Date
2006
MeSH
Administration, Cutaneous ; Adult ; Aged ; Female ; Forearm/surgery* ; Humans ; Hyperparathyroidism/surgery* ; Hyperparathyroidism/therapy ; Kidney Failure, Chronic/physiopathology ; Male ; Middle Aged ; Parathyroid Glands/surgery* ; Parathyroid Glands/transplantation ; Parathyroidectomy/methods* ; Prospective Studies ; Treatment Outcome*
Keywords
Total parathyroidectomy ; Autotransplantation ; Subcutaneous injection technique ; Secondary hyperparathyroidism
Abstract
PURPOSE: To prospectively assess the effectiveness of total parathyroidectomy and autotransplantation using a subcutaneous injection technique to treat secondary hyperparathyroidism.
METHODS: We used this method to treat 14 patients with secondary hyperparathyroidism. The short-term outcome, up to 16 months after surgery, was monitored by measuring calcium, inorganic phosphorus, intact parathyroid hormone (iPTH), and alkaline phosphatase levels. We considered a graft viable when the ratio of iPHT in antecubital venous blood from the grafted arm to that from the nongrafted arm exceeded 1.5.
RESULTS: Autografted parathyroid tissue was functional in 12 (85.7%) patients. An iPTH ratio > or =1.5 in the grafted arm relative to the nongrafted arm was observed from 2 weeks after surgery, peaking at 1 month. The grafted tissue continued to be biochemically functional 16 months after surgery in 12 patients.
CONCLUSION: These findings suggest that total parathyroidectomy and forearm autotransplantation using the subcutaneous injection technique is a possible alternative to Wells' method for surgical treatment of secondary hyperparathyroidism.
Full Text
http://link.springer.com/article/10.1007%2Fs00595-005-3150-0
DOI
10.1007/s00595-005-3150-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Chung, Woong Youn(정웅윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109518
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