Sequential parathyroidectomy under cervical plexus anesthesia for secondary hyperparathyroidism with renal function failure

• Published in: Chung-hua wai kʿo tsa chih Vol. 56; no. 7; p. 528
• Main Authors: Hu, Y, Hua, S R, Wang, M Y, Su, Z, Cui, M, Zhang, X, Liao, Q, Zhao, Y P
• Format: Journal Article
• Language: Chinese
• Published: China 01.07.2018
• Subjects: Cervical Plexus Block; Female; Humans; Hyperparathyroidism, Secondary - therapy; Male; Middle Aged; Parathyroid Glands; Parathyroid Hormone; Parathyroidectomy; Prospective Studies; Hyperparathyroidism, secondary; Renal insufficiency, chronic; Parathyroidectomy
• ISSN: 0529-5815
• DOI: 10.3760/cma.j.issn.0529-5815.2018.07.009

To summarize the strategy of sequential parathyroidectomy for secondary hyperparathyroidism. Between January 2009 and December 2017, 32 patients with secondary hyperparathyroidism underwent parathyroidectomy in Department of General Surgery, Peking Union Medical College Hospital. There were 11 male and 21 female patients with a mean age of 51.3 years. Eleven of them underwent bilateral neck exploration under general anesthesia, while the rest of them underwent sequential parathyroidectomy. For the patients with sequential parathyroidectomy, a unilateral neck exploration was performed in the initial operation under cervical plexus blocking anesthesia. Second operation for contralateral parathyroid lesions was performed if the serum intact parathyroid hormone (iPTH) was still higher than 1 000 ng/L or related symptoms were not relieved significantly 6 months later after initial surgery. Fisher exact test was used to compare the date between the 2 groups. In the bilateral exploration group, the serum iPTH level