Quality of life after surgery in secondary hyperparathyroidism, comparing subtotal parathyroidectomy with total parathyroidectomy with immediate parathyroid autograft: Prospective randomized trial

Filho, Wellington Alves; Plas, Willemijn Y. van der; Brescia, Marília D’Elboux Guimarães; Nascimento, Climério Pereira; Goldenstein, Patricia Taschner; Neto, Ledo Mazzei Massoni; Arap, S; Custódio, Melani Ribeiro; Bueno, Rodrigo O.; Moysés, Rosa Maria Affonso; Jorgetti, Vanda; Kruijf, Schelto; Montenegro, Fábio Luiz de Menezes

doi:10.1016/j.surg.2018.06.032

Cited by 30 publications

(19 citation statements)

References 30 publications

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“…There have been many studies on the three surgical methods in the past, but the statistics of laboratory indicators reaching the recommended range of KDIGO guidelines are very rare. Consistent with previous study, our study found that all three surgical approaches can control refractory SHPT [44]. As previous studies have shown, S-PTX seems to be able to control SHPT well with fewer complications [45,46].…”

Section: Discussionsupporting

confidence: 92%

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

et al. 2019

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Objectives: The aim of the study was to evaluate the laboratory parameters and symptoms after parathyroidectomy (PTX) in dialysis patients with secondary hyperparathyroidism (SHPT), and to briefly analyze the different therapeutic effects of the three surgical methods. Methods: A total of 182 dialysis patients who underwent PTX between February 2012 and January 2018 at the Second Affiliated Hospital of Soochow University were included in this study and followed for 12 months. Laboratory parameters such as calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) were measured before and after operation. According to the follow-up time and type of operation, we calculated the percentage of laboratory indicators reaching the recommended range of the KDIGO guidelines after surgery. We also analyzed the improvement of bone pain and pruritus, as well as surgical complications. Results: After the operation, the levels of iPTH, Ca, and P decreased significantly at each time point. ALP increased at the first postoperative week and gradually decreased to normal range after 3 months. Symptoms, such as bone pain and pruritus, were significantly relieved. According to the follow-up time and three surgical methods (subtotal parathyroidectomy, total parathyroidectomy, total parathyroidectomy plus autologous transplantation), we found that the ratio of each laboratory parameter reaching the recommended range of KDIGO guidelines was significantly different. Conclusion: PTX is a safe and effective therapy for treating SHPT that is refractory to medical therapies and accompanied by related signs and symptoms in dialysis patients. All three operative techniques were effective in controlling SHPT.

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Section: Discussionsupporting

confidence: 92%

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

et al. 2019

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“…In our study the median RE score at time of diagnosis was higher (51.23±4.80) compared with the previous study and did not improve to the same magnitude following parathyroidectomy. [16] Another explanation may be more than half patients were asymptomatic. In four RCTs only including asymptomatic PHPT patients using the SF-36 survey, three of the studies observed a modest improvement in two to four of the domains (emotional-, social function, general health, and vitality) in the parathyroidectomy compared to the medical observation group.…”

Section: Resultsmentioning

confidence: 99%

Quality of Life after Total Parathyroidectomy in Patients with Secondary Hyperparathyroidism

Xu¹,

Zhang²,

Zhou³

et al. 2020

Preprint

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Background. Patients with end-stage renal disease (ESRD) have a decreased quality of life (QoL), which is attributable in part to secondary hyperparathyroidism (2HPT). Surgery is the definitive treatment of 2HPT. The aim of this study is to assess the effect of total parathyroidectomy with deltoid autotransplantation on the QoL. Methods: A total of 201 ESRD with 2HPT were enrolled . The operation efficacy was evaluated by analyzing preoperative and postoperative values, including levels of intact parathyroid hormone (iPTH), serum phosphorus, serum calcium, alkaline phosphatase (ALP) and calcium-phosphorus product. The QoL was evaluated by MOS 36-item short-form health survey (SF-36) scores preoperatively and at 6 months postoperation. Results: Compared with the preoperative values, levels of PTH(2033pg/ml vs 62.5 pg/ml), serum phosphorus(2.30mg/dl vs 1.60mg/dl), serum calcium(3.62mg/dl vs 1.84mg/dl), and calcium-phosphorus product were all decreased postoperative. Number variation and anatomic location variation of thyroid glands were found in the patients. Quality of life improved significantly in all 8 individual and 2 component summary scales, with a more significant decrease in the physical health scales. Conclusion: Parathyroidectomy significantly improves quality of life in patients with secondary hyperparathyroidism.

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“…In four randomized controlled trials (RCTs) that included only asymptomatic SHPT patients and used the SF-36 health survey, three of the studies observed a modest improvement in two to four of the domains (emotional, social functioning, general health, and vitality) in the PTX group compared to the medical observation group. [17][18][19] However, the fourth RCT showed ambiguous results with a slight but signi cant difference in scores in favor of surgery in the RE and physical domains, while the mental health subdomain showed higher (better) scores at the 2-year follow-up in favor of the medical observation group. [20] Conclusions Elevated PTH levels are associated with many complications, which can severely compromise the QoL of already impaired SHPT patients.…”

Section: Discussionmentioning

confidence: 98%

Quality of Life after Total Parathyroidectomy in Patients with Secondary Hyperparathyroidism

Zhou

et al. 2020

Preprint

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Background. Patients with end-stage renal disease (ESRD) have a decreased quality of life (QoL), which is attributable in part to secondary hyperparathyroidism (SHPT). Surgery is the definitive treatment for SHPT. The aim of this study is to assess the effect of total parathyroidectomy (PTX) with deltoid autotransplantation on QoL.Methods: A total of 201 ESRD patients with SHPT were enrolled. The operation efficacy was evaluated by analyzing preoperative and postoperative values, including the levels of intact parathyroid hormone (PTH), serum phosphorus, serum calcium, alkaline phosphatase (ALP) and calcium-phosphorus product. The QoL was evaluated by scores on the Medical Outcomes Study 36-item short-form (SF-36) health survey preoperatively and 6 months postoperatively.Results: Compared with preoperatively, postoperatively, the levels of iPTH (2033 pg/ml vs 62.5 pg/ml), serum phosphorus (2.30 mg/dl vs 1.60 mg/dl), serum calcium (3.62 mg/dl vs 1.84 mg/dl), and calcium-phosphorus product were all decreased. Variations in the number and anatomic location of thyroid glands were found in the patients. QoL improved significantly in all 8 individual and 2 component summary scales, with a more significant decrease in the physical health scales.Conclusion: PTX significantly improves QoL in patients with SHPT.

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Quality of life after surgery in secondary hyperparathyroidism, comparing subtotal parathyroidectomy with total parathyroidectomy with immediate parathyroid autograft: Prospective randomized trial

Cited by 30 publications

References 30 publications

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Evaluation of laboratory parameters and symptoms after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Quality of Life after Total Parathyroidectomy in Patients with Secondary Hyperparathyroidism

Quality of Life after Total Parathyroidectomy in Patients with Secondary Hyperparathyroidism

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