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Chirurgia 1999 April;12(2):119-22

language: Italian

Total parathyroidectomy and autotrasplantation. Personal experience

Zaraca F., Mazzaferro S., Alò P., Saputelli A., Di Paola M., Chicca S., Talarico C., Talarico E., La Pinta M., Gossetti F., Proposito D., Santoro R., Montemurro L., Carboni M


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Background. The objective of the present study is to evaluate the clinical effectiveness and the recurrence rate of total parathyroidectomy with autotrasplantation in patients with severe secondary hyperparathyroidism (HPT).
Methods. Nineteen patients were operated on for secondary hyperparathyroidism between March 1993 and March 1996 by the chief surgeon.
Results. Thirteen patients (72.2%) improved and returned to normal clinical and laboratory parameters specific to the manifestation of secondary HPT. One patient died 50 days after surgery. Two patients (11.1%) developed a mild hypoparathyroidism and one patient (5.3%) a persistent HPT, requiring reoperation. Two patients developed recurrent HPT, one of them requiring reoperation.
Conclusions. On the basis of personal experience the conclusion is drawn that PTX+AT is effective in releving the symptoms and has a safe recurrence rate. Nevertheless, the method of choice in the surgical treatment of secondary HPT depends on the surgeon's preference. All the procedures described result in a good control of clinical and biochemical parameters.

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