Langenbeck's Archives of Surgery

, Volume 398, Issue 1, pp 121–130

Current trends in surgery for renal hyperparathyroidism (RHPT)—an international survey

  • Philipp Riss
  • Reza Asari
  • Christian Scheuba
  • Bruno Niederle
Original Article

DOI: 10.1007/s00423-012-1025-6

Cite this article as:
Riss, P., Asari, R., Scheuba, C. et al. Langenbecks Arch Surg (2013) 398: 121. doi:10.1007/s00423-012-1025-6

Abstract

Purpose

The indications and results of preoperative localization, surgical strategy, indication for thymectomy, the application of intraoperative parathyroid hormone (PTH) monitoring, cryopreservation, and replantation of cryopreserved parathyroid tissue are not well documented in renal hyperparathyroidism (RHPT). The current trends in surgery for RHPT are to be evaluated in an international online survey.

Methods

Thirty-three questions regarding preoperative localization, surgical management of RHPT, intraoperative PTH monitoring, immediate/delayed autotransplantation (AT), and parathyroid cryopreservation were sent to members of various societies of endocrine surgeons.

Results

The data from 86 responses were analyzed, 61.6 % reported more than 50 parathyroid surgeries per year, and 62.7 % operated on less than 16 patients with RHPT per year. Subtotal or total parathyroidectomy (with/without AT) was the standard procedure in 98.8 % of the cases. Immediate AT was performed in 40.7 % (72.7 % in the forearm). In most patients, the onset of graft function was documented later than 1 week after AT. Cryopreservation was routinely performed in 27.4 %. In 10.7 %, replantation was performed in more than five patients (hypo- or aparathyroidism: n = 41; fresh graft failure: n = 13; reoperations: n = 9). Intraoperative PTH monitoring (in RHPT) was routinely used in 46.2 %. Its influence on surgical strategy was confirmed in 40 %.

Conclusions

The survey reflects the divergent strategies applied for AT, cryopreservation, and PTH monitoring in RHPT.

Keywords

Renal hyperparathyroidismParathyroid hormone monitoringCryopreservationInternational surveyAutotransplantation

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Philipp Riss
    • 1
  • Reza Asari
    • 1
  • Christian Scheuba
    • 1
  • Bruno Niederle
    • 1
  1. 1.Section of Endocrine Surgery, Division of General Surgery, Department of SurgeryMedical University of ViennaViennaAustria