[Hyperparathyroidism in patients with chronic renal failure: subtotal parathyroidectomy or total parathyroidectomy with autotransplantation? Experience with 121 cases].

Abstract

From 1973 to 1988 121 patients with chronic renal failure underwent parathyroidectomy (PTX) for secondary hyperparathyroidism. The surgical decision was made upon clinical and/or radiological signs and symptoms. Two kinds of operation were performed: Subtotal PTX 87 cases; Total PTX + parathyroid autograft 34 cases. Post-operative results are discussed. For all cases, the authors emphasize: the need of transcervical thymectomy (ectopic supernumerary gland = 17.3%); the need of routine cryopreservation. Subtotal PTX should be the routine operation. Total PTX with autograft is elicited when a combined thyroidectomy is performed, if parathyroid remnant's blood supply is questionable and in case of recurrent Secondary HPT.