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ABSTRACT: IntroductionSecondary hyperparathyroidism is a frequent complication of chronic renal failure. Surgical management may become necessary as the disease progresses, particularly in severe forms resistant to medical therapy. This study aims to clarify the indications for parathyroidectomy and to define the short and long term evolution of the condition.Patients and methodsThis retrospective study involves 16 hemodialysis-dependent patients who underwent parathyroidectomy over a period of 9 years. We analyzed the clinical, biological and radiological parameters pre- and postoperatively.ResultsThe mean age and average duration of hemodialysis patients at the time of surgery were 45 ± 12 years and 10 ± 3 years. The M:F sex ratio was 10:6. After a mean follow-up of 5 years, we found postoperative hypocalcemia in six cases (37.5%), one case of vocal cord palsy due to recurrent nerve injury, and two cases of persistent secondary hyperparathyroidism (12.5%). No case of recurrent hyperparathyroidism was found. The long-term results were favorable in 87.5% of cases who had both clinical and laboratory improvement.Conclusion
Parathyroidectomy effectively decreases the hypersecretion of parathyroid hormone; clinical, biological and radiological results are satisfactory. However, early treatment of abnormal calcium and phosphate levels with newly developed medications and the development of renal transplantation will likely reduce the need for this surgery.
Journal de Chirurgie Viscérale. 01/2010; 147(2):133-138.