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Total parathyroidectomy with presternal intramuscular autotransplantation in renal patients: a prospective study of 66 patients.

Santos RO, Ohe MN, Carvalho AB, Neves MC, Kunii I, Lazaretti-Castro M, Abrahão M, Cervantes O, Vieira JG - J Osteoporos (2012)

Bottom Line: Postoperative average followup was 42.9 months (range: 12-96).Postoperative intact PTH increased throughout followup from 73.5 pg/mL to 133 pg/mL on average from 1st to the 5th year, respectively, in SHPT and from 54.9 pg/mL to 94.7 pg/mL on average from 1st to 5th year, respectively, in THPT group.Definitive hypoparathyroidism was observed in 4 (6.06%) patients and graft-dependent recurrence in 6 (9.09%).

View Article: PubMed Central - PubMed

Affiliation: Department of Head and Neck Surgery, UNIFESP/EPM, São Paulo, SP, Brazil.

ABSTRACT
Surgical treatment of secondary (SHPT) and tertiary hyperparathyroidism (THPT) may involve various surgical approaches. The aim of this paper was to evaluate presternal intramuscular autotransplantation of parathyroid tissue as a surgical option in SHPT and THPT treatment. 66 patients with renal chronic disease underwent surgery from April 2000 to April 2005 at Universidade Federal São Paulo, Brazil. There were 38 SHPT patients (24 women/14 men), mean age of 39.yrs (range: 14-58), and 28 THPT patients (14 women/14 men), mean age of 43.4 yrs (range: 24-62). Postoperative average followup was 42.9 months (range: 12-96). Postoperative intact PTH increased throughout followup from 73.5 pg/mL to 133 pg/mL on average from 1st to the 5th year, respectively, in SHPT and from 54.9 pg/mL to 94.7 pg/mL on average from 1st to 5th year, respectively, in THPT group. Definitive hypoparathyroidism was observed in 4 (6.06%) patients and graft-dependent recurrence in 6 (9.09%). Presternal intramuscular autotransplantation of parathyroid tissue is a feasible and safe surgical option in SHPT and THPT treatment.

No MeSH data available.


Related in: MedlinePlus

Intramuscular presternal grafted area: final aspect.
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Related In: Results  -  Collection


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fig2: Intramuscular presternal grafted area: final aspect.

Mentions: A horizontal 1.5 cm incision was made over the upper one-third of the sternum above left 2nd intercostal space (Figure 2). Pectoralis major muscle insertion at sternum bone [3–5] was identified followed by fascia and muscle fibers dissection in an attempt to perform a 1.5 cm graft pocket where parathyroid fragments were implanted. This grafted area had sternum bone as posterior boundary.


Total parathyroidectomy with presternal intramuscular autotransplantation in renal patients: a prospective study of 66 patients.

Santos RO, Ohe MN, Carvalho AB, Neves MC, Kunii I, Lazaretti-Castro M, Abrahão M, Cervantes O, Vieira JG - J Osteoporos (2012)

Intramuscular presternal grafted area: final aspect.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3306985&req=5

fig2: Intramuscular presternal grafted area: final aspect.
Mentions: A horizontal 1.5 cm incision was made over the upper one-third of the sternum above left 2nd intercostal space (Figure 2). Pectoralis major muscle insertion at sternum bone [3–5] was identified followed by fascia and muscle fibers dissection in an attempt to perform a 1.5 cm graft pocket where parathyroid fragments were implanted. This grafted area had sternum bone as posterior boundary.

Bottom Line: Postoperative average followup was 42.9 months (range: 12-96).Postoperative intact PTH increased throughout followup from 73.5 pg/mL to 133 pg/mL on average from 1st to the 5th year, respectively, in SHPT and from 54.9 pg/mL to 94.7 pg/mL on average from 1st to 5th year, respectively, in THPT group.Definitive hypoparathyroidism was observed in 4 (6.06%) patients and graft-dependent recurrence in 6 (9.09%).

View Article: PubMed Central - PubMed

Affiliation: Department of Head and Neck Surgery, UNIFESP/EPM, São Paulo, SP, Brazil.

ABSTRACT
Surgical treatment of secondary (SHPT) and tertiary hyperparathyroidism (THPT) may involve various surgical approaches. The aim of this paper was to evaluate presternal intramuscular autotransplantation of parathyroid tissue as a surgical option in SHPT and THPT treatment. 66 patients with renal chronic disease underwent surgery from April 2000 to April 2005 at Universidade Federal São Paulo, Brazil. There were 38 SHPT patients (24 women/14 men), mean age of 39.yrs (range: 14-58), and 28 THPT patients (14 women/14 men), mean age of 43.4 yrs (range: 24-62). Postoperative average followup was 42.9 months (range: 12-96). Postoperative intact PTH increased throughout followup from 73.5 pg/mL to 133 pg/mL on average from 1st to the 5th year, respectively, in SHPT and from 54.9 pg/mL to 94.7 pg/mL on average from 1st to 5th year, respectively, in THPT group. Definitive hypoparathyroidism was observed in 4 (6.06%) patients and graft-dependent recurrence in 6 (9.09%). Presternal intramuscular autotransplantation of parathyroid tissue is a feasible and safe surgical option in SHPT and THPT treatment.

No MeSH data available.


Related in: MedlinePlus