CASE ANALYSIS OF THREE TYPES OF PARATHYROIDECTOMY IN TREATING UREMIC SECONDARY HYPERPARATHYROIDISM

Objective: To investigate the symptom relief, postoperative complications, and recurrence in the patients with uremic SHPT after subtotal parathyroidectomy (S-PTX), total parathyroidectomy (T-PTX), or total parathyroidectomy combined with auto-transplantation (PTX+AT). Methods: A total of 92 patients with SHPT undergoing parathyroidectomy in our hospital were retrospectively analyzed. The patients were divided into 3 groups according to their surgical procedures and compared the levels of parathyroid hormone (PTH), calcium (Ca), phosphorus (P), etc. before surgery and one week, one month and six months after surgery, and observed postoperative complications, recurrence rate and symptom improvement among these groups. Results: All the symptoms such as bone pain were relieved to varying degrees in the 3 groups. The postoperative serum levels of Ca, P, and intact PTH (iPTH) decreased in all groups than preoperative values (P<0.05). There was no significant difference in the serum Ca and P among the three groups (P>0.05). The levels of PTH in group S-PTX and group PTX+AT were higher than group T-PTX at the 3 postoperative time points (P<0.05). The 6-month follow-up revealed no difference in recurrence rate among the three groups (P>0.05). Conclusion: The three kinds of parathyroidectomy can all safely and effectively treat uremic SHPT. T-PTX is superior in reducing iPTH to the other two groups.