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Quality of life after surgery in secondary hyperparathyroidism, comparing subtotal parathyroidectomy with total parathyroidectomy with immediate parathyroid autograft: Prospective randomized trial.
- Source :
-
Surgery [Surgery] 2018 Nov; Vol. 164 (5), pp. 978-985. Date of Electronic Publication: 2018 Aug 03. - Publication Year :
- 2018
-
Abstract
- Background: No prospective randomized data exist about the impact of various strategies of parathyroidectomy in secondary hyperparathyroidism patients on quality of life and its possible relationship with metabolic status after the operation.<br />Method: In a prospective randomized trial, the Short Form 36 Health Survey Questionnaire was applied to 69 patients undergoing parathyroidectomy through various approaches: subtotal parathyroidectomy (n = 23), total parathyroidectomy (PTx) with autotransplantation of 45 fragments (n = 25) and PTx with autotransplantation of 90 fragments (n = 21). The questionnaire was completed at three moments: (1) preoperatively, (2) 6 months after surgery, and (3) 12 months after surgery.<br />Results: Quality of life improved significantly in the physical component summary score in all three groups. Subtotal parathyroidectomy scores changed from 30.6 preoperatively to 51.7 6 months after surgery and 53.7 12 months after surgery. Total arathyroidectomy with autotransplantation of 45 fragments scores changed from 33.8 preoperatively to 52.6 6 months after surgery and 55.2 12 months after surgery. Total parathyroidectomy with autotransplantation of 90 fragments scores changed from 31.8 preoperatively to 50.5 6 months after surgery and 55.2 12 months after surgery (all groups P < .0001). No significant difference was detected in the physical component summary score change among the three groups. The physical component summary score was negatively correlated to age, parathormone, and alkaline phosphatase preoperatively.<br />Conclusion: Parathyroidectomy significantly improves quality of life in hemodialysis patients with secondary hyperparathyroidism, regardless of the type of operation.<br /> (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Age Factors
Female
Follow-Up Studies
Humans
Hyperparathyroidism, Secondary blood
Hyperparathyroidism, Secondary etiology
Kidney Failure, Chronic blood
Kidney Failure, Chronic complications
Kidney Failure, Chronic therapy
Male
Middle Aged
Parathyroid Hormone blood
Parathyroidectomy adverse effects
Preoperative Period
Prospective Studies
Renal Dialysis adverse effects
Surveys and Questionnaires statistics & numerical data
Transplantation, Autologous adverse effects
Transplantation, Autologous methods
Treatment Outcome
Hyperparathyroidism, Secondary surgery
Parathyroid Glands transplantation
Parathyroidectomy methods
Quality of Life
Subjects
Details
- Language :
- English
- ISSN :
- 1532-7361
- Volume :
- 164
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30082137
- Full Text :
- https://doi.org/10.1016/j.surg.2018.06.032