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KMID : 1188520110070010052
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Korean Journal of Clinical Oncology
2011 Volume.7 No. 1 p.52 ~ p.59
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The Postoperative Outcomes of Patients with Primary, Secondary and Tertiary Hyperparathyroidism : 14 Year Experience of Seoul National University Hospital
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Choi Yun-Suk
Park Kwi-Won
Roh Dong-Young
Lee Kyu-Eun
Oh Eun-Mee
Choi June-Young
Youn Yeo-Kyu
Oh Seung-Keun
Koo Do-Hoon
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Abstract
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Purpose: Primary hyperparathyroidism(PHPT), secondary hyperparathyroidism(SHPT) and tertiary hyperparathyroidism(THPT) are different in the cause, treatment and prognosis. However the parathyroidectomy has been an efficient treatment in all hyperparathyroidism groups. A single institution`s 14 year experience of surgical treatment was analyzed to investigate perioperative changes of clinical characteristics and reconsider the value of parathyroidectomy as the treatment option.
Materials and Methods : From 1996 to 2009, 126 patients underwent parathyroidectomy at single institute and the number of patients with PHPT, SHPT and THPT were 96, 24 and 6 retrospectively. The electronic medical records of age, sex, biochemical analysis, operative method, and pathologic results were reviewed retrospectively.
Results: Postoperative calcium (Ca), parathyroid hormone (PTH), ionized calcium (iCa) levels were improved definitely than preoperative Ca, PTH, iCa level in all three groups. Pre and postoperative PTH level in SHPT was higher than in PHPT and THPT(p< 0.001, p= 0.036) and postoperative persistent PTH increased status were more common in SHPT.(30.4%, p< 0.001) Postoperative temporary hypocalcemia was more common in SHPT(87.5%, p< 0.001), almost of them (90.4%) were recovered in 6 month. In SHPT group, temporary hypocalcemia were more common in subtotal or total parathyroidectomy group than in limited resection group (94.1%) but persistent iPTH increase were more common in limited resection group (50%). .
Conclusion: Parathyroidectomy is highly recommended to improve biochemical laboratory findings in patients with hyperparathyroidism. And in SHPT, subtotal or total parathyroidectomy is more appropriate surgical method for reducing the high incidence of persistent hyperparathyroidism.
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KEYWORD
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Hyperparathyroidism, Persistent hyperaparathyroidism, Temporary hypocalcemia
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