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.
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, intactparathyroid 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.
Authors: A L Feldman; R N Sharaf; M C Skarulis; D L Bartlett; S K Libutti; L S Weinstein; S J Marx; J A Norton; D L Fraker; H R Alexander Journal: Surgery Date: 1999-12 Impact factor: 3.982
Authors: Hae Sang Park; Soo Yeon Jung; Ha Yeong Kim; Du Young Ko; Sung Min Chung; Byeongmoon Jeong; Han Su Kim Journal: Eur Arch Otorhinolaryngol Date: 2016-03-19 Impact factor: 2.503