Long term results of total parathyroidectomy/autotransplantation without cryopreservation in secondary hyperparathyroidism

Yıl 2018, Cilt: 43 Sayı: Ek 1, 129 - 138, 29.12.2018

Tevfik Avcı Feza Yarbuğ Karakayalı Hakan Yabanoğlu Gökhan Moray

https://doi.org/10.17826/cumj.398492

Cited By: 1

Öz

Purpose: The aim of this study was to compare the efficacy and early-late results of subtotal parathyroidectomy and total parathyroidectomy/auto transplantation without cryopreservation conducted on cases with secondary hyperparathyroidism (HPT). 

Materials and Methods: 68 patients with secondary HPT who had parathyroidectomy were analysed retrospectively. In group1 (n=47) subtotal parathyroidectomy, in group2 (n=21) total parathyroidectomy/auto transplantation without cryopreservation were performed in our clinic. Patients' demographic characteristics and clinical features were evaluated.  

Results: In group1 8 patients (14.9%), in group2 17 patients (76.2%) had concurrent thymectomies. The rates of persistant HPT in group1 and group2 were 14.9% (n=7), 4.8% (n=1) respectively. In group2 no recurrent HPT was seen, in group2 10.6% (n=5) of the patients had recurrent HPT. The reasons of  persistent and recurrent HPT were ectopic or supernumerary glands in 69.2% (n=9) of the patients.  

Conclusion: In patients with end stage renal failure and secondary HPT, bilateral cervical thymectomy concurrent with total parathyroidectomy/auto transplantation without cryopreservation can be applied as a safe and efficient surgical procedure.

Anahtar Kelimeler

Hyperparathyroidism, secondary, parathyroidectomy, autotransplantation, thymectomy

Sekonder hiperparatiroidizm olgularında kriyoprezervasyonsuz total paratiroidektomi/önkol ototransplantasyon tekniğinin uzun dönem sonuçları

Öz

Amaç: Bu çalışmada, kliniğimizde sekonder hiperparatiroidizm (HPT) olgularına uygulanan subtotal paratiroidektomi ve kriyoprezervasyonsuz total paratiroidektomi ve ototransplantasyon cerrahi yöntemlerinin erken ve geç dönem sonuçları ve etkinliklerinin karşılaştırılması amaçlanmıştır.

Gereç ve Yöntem: Çalışmaya paratiroidektomi yapılan 68 sekonder HPT hastası dahil edildi ve hastalar retrospektif olarak değerlendirildi. Subtotal paratiroidektomi yapılan hastalar grup 1 (n=47) olarak, total paratiroidektomi ve ototransplantasyon yapılan hastalar grup 2 (n=21) olarak sınıflandırıldı. Hastaların demografik ve klinik özellikleri değerlendirildi.

Bulgular: Ameliyatta, grup 1’de 8 hastaya (%14.9), grup 2’de 17 hastaya (%76.2) eş zamanlı timektomi yapıldı. Grup 1’de görülen persistan hiperparatiroidi (HPT) oranı %14.9 (n=7) iken, grup 2’de %4.8 (n=1) idi. Rekürren HPT grup 2’de görülmezken, grup 1’de %10.6 oranında (n=5) görüldü. Tüm hastalar değerlendirildiğinde, persistan veya rekürren HPT gelişen hastaların %69.2’sinde (n=9) neden, ektopik veya süpernumara bez varlığıydı.

Sonuç: Son dönem böbrek yetmezlikli sekonder HPT tanılı hastalara, bilateral servikal timektominin eklendiği, kriyoprezervasyonsuz total paratiroidektomi ve ototransplantasyon tekniği, güvenli ve etkili bir cerrahi seçenek olarak uygulanabilir.

Anahtar Kelimeler

Sekonder hiperparatiroidi, total paratiroidektomi, ototransplantasyon, subtotal paratiroidektomi

Kaynakça

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