Issues

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

Keywords

Chronic renal failure, parathyroidectomy, vitaminD

Summary

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.

You may also be interested in...

1.

P. M. Jehle (1, 2, 3), D. Jehle (2, 3), M. Jentzsch (2, 3)

Osteologie 2017 26 3: 135-138