Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-28T07:11:12.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Re-operation for secondary hyperparathyroidism

Published online by Cambridge University Press:  30 November 2007

F Debruyne ,
G Geuens ,
V Vander Poorten  and
P Delaere
F Debruyne*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
G Geuens
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
V Vander Poorten
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
P Delaere
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
*
Address for correspondence: Dr Frans Debruyne, Department of Otorhinolaryngology, Head and Neck Surgery, UZ St Rafael, Kapucijnenvoer 33, 3000 Leuven, Belgium. Fax: +32 16 332335 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

In cases of re-operation for secondary hyperparathyroidism, to evaluate the extent to which the location of recurrent hyperplasia was predicted by (1) operative data from the first intervention, and (2) pre-operative imaging (before the re-operation).

Methods:

The files of 18 patients undergoing surgery for recurrent secondary hyperparathyroidism were reviewed. The surgical findings were compared both with the report of the initial operation and with the results of pre-operative imaging (i.e. ultrasonography, Mibi scintigraphy or computed tomography).

Results:

The location of the recurrent hyperplasia corresponded with the data for the primary intervention in about one-third of patients. There was a partial correlation in one-third of patients, and no correlation at all in one-third. Pre-operative imaging enabled better prediction of the location of recurrent disease.

Conclusion:

Surgeons should have both sources of information at their disposal when planning a re-intervention for secondary hyperparathyroidism. However, in our series, the predictive value of imaging was superior to that of information deduced from the previous surgical record.

Keywords

Secondary HyperparathyroidismParathyroidectomyRevision Surgery
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 9 , September 2008 , pp. 942 - 947
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Llach, F. Secondary hyperparathyroidism in renal failure: the trade off hypothesis revisited. Am J Kidney Dis 1995;25:663–79CrossRefGoogle ScholarPubMed
2 Tominaga, Y. Management of renal hyperparathyroidism. Biomed Pharmacother 2000;1:25–31CrossRefGoogle Scholar
3 Cattan, P, Halimi, B, Aidan, K, Billotey, C, Tamas, C, Drüeke, TB et al. Reoperation for secondary uremic hyperparathyroidism: are technical difficulties influenced by initial surgical procedure? Surgery 2000;127:562–5CrossRefGoogle ScholarPubMed
4 Rothmund, M, Wagner, M, Schark, C. Subtotal parathyroidectomy versus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial. World J Surg 1991;15:745–50CrossRefGoogle ScholarPubMed
5 Tominaga, Y, Tanaka, Y, Sato, K, Numano, M, Uchida, K, Falkmer, U et al. Recurrent renal hyperparathyroidism and DNA analysis of autografted parathyroid tissue. World J Surg 1992;16:595–603Google Scholar
6 Numano, M, Tominaga, Y, Uchida, K, Orihara, A, Tanaka, Y, Takagi, H. Surgical significance of supernumerary parathyroid glands in renal hyperparathyroidism. World J Surg 1998;22:1098–103CrossRefGoogle ScholarPubMed
7 Henry, JF, Denizot, A, Audiffret, J, France, G. Results of reoperations for persistent or recurrent secondary hyperparathyroidism in hemodialysis patients. World J Surg 1990;14:303–7Google Scholar
8 Tanaka, Y, Seo, H, Tominaga, Y, Funahashi, H, Matsui, N, Takagi, H. Factors related to the recurrent hyperfunction of autografts after total parathyroidectomy in patients with severe secondary hyperparathyroidism. Surg Today 1993;23:220–7CrossRefGoogle Scholar
9 Walgenbach, S, Hommel, G, Junginger, T. Prospective evaluation of parathyroid graft function after total parathyroidectomy and heterotopic autotransplantation in renal hyperparathyroidism by bilateral determination of intact parathormone in cubital venous blood. World J Surg 1998;22:93–8CrossRefGoogle ScholarPubMed
10 Neonakis, E, Wheeler, MH, Krishnan, H, Coles, GA, Davies, F, Woodhead, JS. Results of surgical treatment of renal hyperparathyroidism. Arch Surg 1995;130:643–8Google Scholar
11 Richards, ML, Wormuth, J, Bingener, J, Sirinek, K. Parathyroidectomy in secondary hyperparathyroidism: is there an optimal operative management? Surgery 2006;139:174–80Google Scholar
12 Tominaga, Y, Katayama, A, Sato, T, Matsuoka, S, Goto, N, Haba, T et al. Re-operation is frequently required when parathyroid glands remain after initial parathyroidectomy for advanced secondary hyperparathyroidism in uraemic patients. Nephrol Dial Transplant 2003;18:65–70Google Scholar
13 Debruyne, F, Ostyn, F, Delaere, P. Weight characteristics of the parathyroid glands in renal hyperparathyroidism. Head Neck 2000;22:509–133.0.CO;2-N>CrossRefGoogle ScholarPubMed
14 Hibi, Y, Tominaga, Y, Uchida, K, Takagi, H, Imai, T, Funahashi, H et al. Cases with fewer than four parathyroid glands in patients with renal hyperparathyroidism at initial parathyroidectomy. World J Surg 2002;26:314–17CrossRefGoogle ScholarPubMed
15 Pattou, FN, Pellissier, LC, Noel, C, Wambergue, F, Huglo, DG, Proye, CA. Supernumerary parathyroid glands: frequency and surgical significance in treatment of renal hyperparathyroidism. World J Surg 2000;24:1330–4Google Scholar
16 Sokol, MS, Kavolius, J, Schaaf, M, D'Avis, J. Recurrent hyperparathyroidism from benign neoplastic seeding: a review with recommendations for management. Surgery 1993;113:456–461Google ScholarPubMed
17 Stehman-Breen, C, Muirhead, N, Thorning, D, Sherrard, D. Secondary hyperparathyroidism complicated by parathyromatosis. Am J Kidney Dis 1996;28:502–7CrossRefGoogle ScholarPubMed
18 Kollmorgen, CF, Aust, MR, Ferreiro, JA, McCarthy, JT, van Heerden, JA. Parathyromatosis: a rare yet important cause of persistent or recurrent hyperparathyroidism. Surgery 1994;116:111–15Google ScholarPubMed
19 Clements, RH, Kent, RB. Preoperative needle-localized parathyroidectomy for persistent secondary hyperparathyroidism. Am Surg 1996;62:413–15Google Scholar
20 Takebayashi, S, Hidai, H, Chiba, T. Hyperfunctional parathyroid glands with 99mTc-Mibi scan: semiquantitative analysis correlated with histological findings. J Nucl Med 1999;40:1792–7Google Scholar
21 Ihibashi, M, Nishida, H, Hiromatsu, Y. Localization of ectopic parathyroid glands using technetium-99 m sestamibi imaging: comparison with magnetic resonance and computed tomography imaging. Eur J Nucl Med 1997;4:197–201CrossRefGoogle Scholar
22 Shen, W, Duren, M, Morita, E. Reoperation for persistent or recurrent primary hyperparathyroidism. Arch Surg 1996;131:861–9CrossRefGoogle ScholarPubMed
23 Carneille, B, Oudar, C, Combemale, F, Huglo, D, Noël, C, Wambergue, F et al. Limits of parathyroid scintigraphy before surgery for hyperparathyroidism of renal origin. Ann Chir 1998;52:374–8Google Scholar
24 Olaizola, I, Zingraff, J, Heuguerot, C. 99 m Tc-sestamibi parathyroid scintigraphy in chronic haemodialysis patients: static and dynamic explorations. Nephrol Dial Transplant 1999;15:1201–6CrossRefGoogle Scholar