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Experience With Subtotal Parathyroidectomy for "Tertiary" Hyperparathyroidism
John B. Eilert, MD;
Donald Casey, MD;
Francesco del Greco, MD;
Julius Conn, Jr., MD
AMA Arch Surg. 1971;103(2):303-307.
Abstract
Five patients out of a group of 75 with advanced renal failure with evidence of tertiary hyperparathyroidism have been treated by subtotal parathyroid excision. Prior to surgery all patients were receiving chronic dialysis. Four patients developed signs and symptoms of hyperparathyroidism resistant to medical therapy in the course of dialysis, and one following transplantation of a cadaveric kidney. This latter patient also developed widespread metastatic calcifications of soft tissue and severe vascular insufficiency. Each of the five patients had 3 or 3 parathyroid glands removed. Response to surgery was assessed by biochemical, radiological, and clinical criteria. Results ranged from poor in one patient to fair in three patients and were excellent in one.
Author Affiliations
Chicago
From the departments of surgery (Drs. Eilert, Casey, and Conn) and medicine (Dr. del Greco) Northwestern University Medical School, Chicago.
Footnotes
Accepted for publication March 31, 1971.
Read before the 28th annual meeting of the Central Surgical Association, Minneapolis, March 5, 1971.
Reprint requests to 303 E Chicago Ave, Chicago 60611 (Dr. Conn).
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