Total parathyroidectomy without autotransplantation and without thymectomy

Journal: Osteologie
ISSN: 1019-1291
Issue: Issues of 2009 (Vol. 18): Issue 2 2009 (73-168)
Pages: 125-127

Total parathyroidectomy without autotransplantation and without thymectomy

S. Stracke (1), F. Keller (2), D. Henne-Bruns (3), G. Steinbach (4), P. Würl (3)
(1) Nephrologie der Universitätsklinik Greifswald; (2) Nephrologie der Universitätsklinik Ulm; (3) Allgemein-, Viszeral- und Transplantationschirurgie der Universitätsklinik Ulm; (4) Klinische Chemie der Universitätsklinik Ulm


Chronic renal failure, parathyroidectomy, vitaminD


Hyperparathyroidism secondary to chronic renal failure (sHPT) leads to renal osteodystrophy – recently renamed chronic kidney disease-mineral and bone disorder (CKD-MBD) – and to progressive extraosseous calcification, especially of blood vessels. Indications for parathyroidectomy (PTX) comprise failure of conventional therapy with phosphate binders, active vitaminD and calcimimetics as well as a bone biopsy showing hyperparathyroid bone disease, sonographically enlarged parathyroid glands, pathological fractures and/ or calciphylaxis. PTX can be performed in several variants: subtotal or total PTX with/without thymectomy and with/without autotransplantation of parathyroid tissue. We favour total parathyroidectomy without autotransplantation and without thymectomy. This is a safe, cost effective procedure with a low recurrency rate for sHPT. It is postoperatively easily manageable and allows for adequate dosage of active vitamin D.

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