Skip to main content
SpringerLink
Log in

Total Parathyroidectomy and Autotransplantation by the Subcutaneous Injection Technique in Secondary Hyperparathyroidism

  • Original Articles
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To prospectively assess the effectiveness of total parathyroidectomy and autotransplantation using a subcutaneous injection technique to treat secondary hyperparathyroidism.

Methods

We used this method to treat 14 patients with secondary hyperparathyroidism. The short-term outcome, up to 16 months after surgery, was monitored by measuring calcium, inorganic phosphorus, intact parathyroid hormone (iPTH), and alkaline phosphatase levels. We considered a graft viable when the ratio of iPHT in antecubital venous blood from the grafted arm to that from the nongrafted arm exceeded 1.5.

Results

Autografted parathyroid tissue was functional in 12 (85.7%) patients. An iPTH ratio ≥1.5 in the grafted arm relative to the nongrafted arm was observed from 2 weeks after surgery, peaking at 1 month. The grafted tissue continued to be biochemically functional 16 months after surgery in 12 patients.

Conclusion

These findings suggest that total parathyroidectomy and forearm autotransplantation using the subcutaneous injection technique is a possible alternative to Wells' method for surgical treatment of secondary hyperparathyroidism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. GM Hargrove JL Pasieka DA Hanley MB Murphy (1999) ArticleTitleShort- and long-term outcome of total parathyroidectomy with immediate autografting versus subtotal parathyroidectomy in patients with end-stage renal disease Am J Nephrol 19 559–64 Occurrence Handle10.1159/000013520 Occurrence Handle1:STN:280:DC%2BD3c%2FksVelsg%3D%3D Occurrence Handle10575184

    Article  CAS  PubMed  Google Scholar 

  2. DM Glassford AR Remmers SuffixJr HE Sarles JD Lindley MT Scurry JC Fish (1976) ArticleTitleHyperparathyroidism in the maintenance dialysis patient Surg Gynecol Obstet 142 328–32 Occurrence Handle1:STN:280:CSmC3s%2Fhslw%3D Occurrence Handle1251311

    CAS  PubMed  Google Scholar 

  3. M Rothmund PK Wagner C Schark (1991) ArticleTitleSubtotal parathyroidectomy versus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial World J Surg 15 745–50 Occurrence Handle1:STN:280:By2C3Mnls1Q%3D Occurrence Handle1767541

    CAS  PubMed  Google Scholar 

  4. M Rothmund PK Wagner (1983) ArticleTitleTotal parathyroidectomy and autotransplantation of parathyroid tissue for renal hyperparathyroidism. A one- to six-year follow-up Ann Surg 197 7–16 Occurrence Handle1:STN:280:BiyD2szmtFM%3D Occurrence Handle6848057

    CAS  PubMed  Google Scholar 

  5. SW Stanbury GA Lumb WF Nicholson (1960) ArticleTitleElective subtotal parathyroidectomy for renal hyperparathyroidism Lancet 1 793–9 Occurrence Handle1:STN:280:CC%2BB3cvksF0%3D Occurrence Handle13833730

    CAS  PubMed  Google Scholar 

  6. DA Albertson GV Poole SuffixJr RT Myers (1985) ArticleTitleSubtotal parathyroidectomy versus total parathyroidectomy with autotransplantation for secondary hyperparathyroidism Am Surg 51 16–20 Occurrence Handle1:STN:280:BiqD1MrislM%3D Occurrence Handle3966718

    CAS  PubMed  Google Scholar 

  7. H Takagi Y Tominaga K Uchida N Yamada M Kawai T Kano et al. (1984) ArticleTitleSubtotal versus total parathyroidectomy with forearm autograft for secondary hyperparathyroidism in chronic renal failure Ann Surg 200 18–23 Occurrence Handle1:STN:280:BiuB3s%2Fis1I%3D Occurrence Handle6732323

    CAS  PubMed  Google Scholar 

  8. M Albertucci CM Zielinski M Rothberg A Sterpetti R Klingman JF Ronk (1998) ArticleTitleSurgical treatment of the parathyroid gland in patients with end-stage renal disease Surg Gynecol Obstet 167 IssueID1 49–52

    Google Scholar 

  9. M Rothmund PK Wagner (1984) ArticleTitleAssessment of parathyroid graft function after autotransplantation of fresh and cryopreserved tissue World J Surg 8 527–33 Occurrence Handle1:STN:280:BiqD3MfksFQ%3D Occurrence Handle6485350

    CAS  PubMed  Google Scholar 

  10. Y Tominaga H Johansson H Johansson H Takagi (1997) ArticleTitleSecondary hyperparathyroidism: pathophysiology, histopathology, and medical and surgical management Surg Today 27 787–92 Occurrence Handle1:STN:280:ByiH2M7msFA%3D Occurrence Handle9306599

    CAS  PubMed  Google Scholar 

  11. U Frei I Klempa M Schneider EH Scheuermann KM Koch (1981) ArticleTitleTumour-like growth of parathyroid autografts in uraemic patients Proc Eur Dial Transplant Assoc 18 548–55 Occurrence Handle1:STN:280:Bi2C38jksVw%3D Occurrence Handle7329983

    CAS  PubMed  Google Scholar 

  12. FF Chou HM Chan TJ Huang CH Lee KT Hsu (1998) ArticleTitleAutotransplantation of parathyroid glands into subcutaneous forearm tissue for renal hyperparathyroidism Surgery 124 1–5 Occurrence Handle1:STN:280:DyaK1czislOntA%3D%3D Occurrence Handle9663244

    CAS  PubMed  Google Scholar 

  13. JM Monchik C Bendinelli MA Passero SuffixJr KK Roggin (1999) ArticleTitleSubcutaneous forearm transplantation of autologous parathyroid tissue in patients with renal hyperparathyroidism Surgery 126 1152–9 Occurrence Handle10.1067/msy.2099.101427 Occurrence Handle1:STN:280:DC%2BD3c%2Fms1Wnug%3D%3D Occurrence Handle10598201

    Article  CAS  PubMed  Google Scholar 

  14. P Kinnaert I Salmon C Decoster-Gervy A Vienne L De Pauw L Hooghe et al. (2000) ArticleTitleLong-term results of subcutaneous parathyroid grafts in uremic patients Arch Surg 135 186–90 Occurrence Handle1:STN:280:DC%2BD3c7jt1elsQ%3D%3D Occurrence Handle10668879

    CAS  PubMed  Google Scholar 

  15. H Hidai T Chiba Y Takagi T Mori T Taniguchi T Hyodo (1998) ArticleTitlePercutaneous autotransplantation of parathyroid tissue into the forearm muscles Surg Today 28 114–6 Occurrence Handle10.1007/s005950050091 Occurrence Handle1:STN:280:DyaK1c7ms1agsw%3D%3D Occurrence Handle9505332

    Article  CAS  PubMed  Google Scholar 

  16. A Saxe (1984) ArticleTitleParathyroid transplantation: a review Surgery 95 507–26 Occurrence Handle1:CAS:528:DyaL2cXksFalsr0%3D Occurrence Handle6369595

    CAS  PubMed  Google Scholar 

  17. LE Mallette K Eisenberg H Wilson GP Noon (1983) ArticleTitleGeneralized primary parathyroid hyperplasia: studies of the evolution of autologous parathyroid graft function Surgery 93 254–9 Occurrence Handle1:STN:280:BiyC38%2Fmt1M%3D Occurrence Handle6823663

    CAS  PubMed  Google Scholar 

  18. S Walgenbach G Hommel T Junginger (1998) ArticleTitleProspective evaluation of parathyroid graft function after total parathyroidectomy and heterotopic autotransplantation in renal hyperparathyroidism by bilateral determination of intact parathormone in cutital venous blood World J Surg 22 93–8 Occurrence Handle10.1007/s002689900355 Occurrence Handle1:STN:280:DyaK1c7is12itA%3D%3D Occurrence Handle9465768

    Article  CAS  PubMed  Google Scholar 

  19. CY Lo SC Tam (2001) ArticleTitleParathyroid autotransplantation during thyroidectomy: documentation of graft function Arch Surg 136 1381–5 Occurrence Handle1:STN:280:DC%2BD38%2FivVyhtQ%3D%3D Occurrence Handle11735864

    CAS  PubMed  Google Scholar 

  20. M Herrera C Grant JA van Heerden LA Fitzpatrick (1992) ArticleTitleParathyroid autotransplantation Arch Surg 127 825–30 Occurrence Handle1:STN:280:By2A1Mfkt1U%3D Occurrence Handle1524483

    CAS  PubMed  Google Scholar 

  21. AL Feldman RN Sharaf MC Skarulis DL Bartlett SK Libutti LS Weinstein et al. (1999) ArticleTitleResults of heterotopic parathyroid autotransplantation: a 13-year experience Surgery 126 1042–8 Occurrence Handle10.1067/msy.2099.101580 Occurrence Handle1:STN:280:DC%2BD3c%2Fms1WgsQ%3D%3D Occurrence Handle10598186

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752, Korea

    Kee-Hyun Nam, Hang-Seok Chang, Woong Youn Chung & Cheong Soo Park

  2. Department of Surgery, Hallym University College of Medicine, Seoul, Korea

    Jong Ho Yoon

Authors
  1. Jong Ho Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kee-Hyun Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hang-Seok Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Woong Youn Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cheong Soo Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yoon, J., Nam, KH., Chang, HS. et al. Total Parathyroidectomy and Autotransplantation by the Subcutaneous Injection Technique in Secondary Hyperparathyroidism. Surg Today 36, 304–307 (2006). https://doi.org/10.1007/s00595-005-3150-0

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-005-3150-0

Key words

Search

Navigation