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Invited Critique: Prospective Evaluation of Total Parathyroidectomy and Autotransplantation for the Treatment of Secondary Hyperparathyroidism
James Norman, MD
University of South Florida
Tampa
Arch Surg. 1999;134:72.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Advanced secondary (renal) hyperparathyroidism (HPT) induced by long-standing chronic renal insufficiency can be a serious complication for patients receiving long-term hemodialysis. As Zaraca and colleagues have pointed out, parathyroidectomy is indicated for patients with advanced secondary HPT that is refractory to medical management; many patients feel dramatically better within days of the operation. The questions that remain, therefore, are when to operate and which operation to perform. Zaraca et al address the second question.
Since 1960, the surgical treatment of secondary HPT has evolved from total parathyroidectomy, to subtotal parathyroidectomy, to total parathyroidectomy with autotransplantation of a portion of 1 gland. The reason that all surgeons are not performing the same operation is that it is unclear which of the latter 2 of these operations has superior long-term results. Although most surgeons have abandoned total parathyroidectomy, numerous reports describe relatively equal short- and long-term clinical success rates . . . [Full Text of this Article]
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Prospective Evaluation of Total Parathyroidectomy and Autotransplantation for the Treatment of Secondary Hyperparathyroidism
Francesco Zaraca, Sandro Mazzaferro, Marco Catarci, Alessandra Saputelli, Piero Alò, and Manlio Carboni
Arch Surg. 1999;134(1):68-72.
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