Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases

İRFANOĞLU, Mehmet Emin; SEZER, Atakan

Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases

Atakan SEZER, (Trakya Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Edirne, Türkiye)

Mehmet Emin İRFANOĞLU (Trakya Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Edirne, Türkiye)

Trakya Üniversitesi Tıp Fakültesi Dergisi

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Yıl: 2009 Cilt: 26 Sayı: 4 Sayfa Aralığı: 331 - 337 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases

Öz:

Amaç: Son dönem böbrek hastalığı dünya çapında bir sağlık problemidir. Bu hastaların yaşam süreleri uzadıkça sekonder hiperparatiroidizm gibi ek patolojiler de gelişmektedir. Bu çalışmanın amacı sekonder hiperparatiroidizme cerrahi yaklaşımları gözden geçirmek ve kendi tecrübelerimizi sunmaktır.Hastalar ve Yöntemler: Bu retrospektif çalışmaya 2004 ve 2008 yılları arasında kronik böbrek hastalığı tanısıyla ameliyat edilen beş erkek hasta (ort. yaş 38.6) dahil edildi. Hasta bilgileri hastane kayıtlarından toplandı.Bulgular: Hastaların ortalama hemodiyaliz süresi 106.8 aydı. Bütün hastalar ameliyat öncesi dönemde ultrasonografi ve sintigrafi ile incelendi. Hastaların ameliyat öncesi ve sonrası dönemde ortalama serum PTH değeri 2097 ng/ ml ve 36.5 ng/dl, Ca 11.48 mg/dl ve 6.2 mg/dl, P 7.5 mg/dl ve 4.4 mg/dl, ALP 527 IU/L ve 89 IU/L idi. Bütün hastalara total paratiroidektomi ve sternokleidomastoid kasa ototransplantasyon yapılırken bir hastaya ek olarak sağ tiroidektomi yapıldı. Ameliyat sonrası dönemde tüm hastalar oral kalsiyum karbonat ve kalsitriol kullandılar. Hiçbir hastada ciddi komplikasyon görülmedi. Ortalama hastanede kalış süresi 4.6 gündü. Hastaların hepsinde serum PTH düzeyleri 300 ng/dl altında seyretti ve hiçbir hastada takipler esnasında nüks hiperparatiroidizm görülmedi.Sonuç: Sekonder hiperparatiroidizmin cerrahi tedavisi için birçok yöntem olsa da total paratiroidektomi ve ototransplantasyon düşük nüks ve komplikasyon oranları ile son dönem böbrek hastalarında gelişen sekonder hiperparatiroidizmin için en kabul edilen tedavi metotlarındandır.

Anahtar Kelime: Böbrek yetmezliği, kronik Hiperparatiroidi, sekonder Paratiroidektomi Geriyedönük çalışma

Konular: Genel ve Dahili Tıp

Son dönem böbrek hastalarında gelişen sekonder hiperparatiroidizmin cerrahi tedavisi: Cerrahi yaklaşımlar ve olgu sunumları

Öz:

Objectives: End-stage renal disease is a worldwide public health problem. While the survival time of the patients extends, additional pathologies such as secondary hyperparathyroidism occurs. The aim of the study is to review the surgical approaches to secondary hyperparathyroidism and present our experiences.Patients and Methods: This retrospective study included five male patients (mean age 38.6 years) who were operated on for chronic renal failure between 2004 and 2008. The data of patients were collected from hospital records.Results: The mean duration of hemodialysis was 106.8 months. All patients had ultrasonography and scintigraphy preoperatively. The mean value of preoperative and postoperative serum PTH was 2097 ng/ml and 36.5 ng/dl, Ca 11.48 mg/dl and 6.2 mg/dl, P 7.5 mg/dl and 4.4 mg/dl, ALP 527 IU/L and 89 IU/L. Total parathyroidectomy and sternocleidomastoid muscle autotransplantation was performed in all patients and one patient had right thyroidectomy in addition. Postoperatively, all patients received oral calcium carbonate and calcitriol. No serious postoperative complications occurred in any of these cases. The duration of hospitalization was 4.6 days on the average. Serum PTH was kept constantly below 300 ng/L in all cases in follow-up and no recurrent hyperparathyroidism was detected.Conclusion: Although there are many types of surgery techniques in treatment of secondary hyperparathyroidism, total parathyroidectomy with autografting is the most accepted procedure with low recurrent and complication rate in end-stage renal disease patients.

Anahtar Kelime: Parathyroidectomy Retrospective Studies Kidney Failure, Chronic Hyperparathyroidism, Secondary

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	SEZER A, İRFANOĞLU M (2009). Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. , 331 - 337.
Chicago	SEZER Atakan,İRFANOĞLU Mehmet Emin Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. (2009): 331 - 337.
MLA	SEZER Atakan,İRFANOĞLU Mehmet Emin Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. , 2009, ss.331 - 337.
AMA	SEZER A,İRFANOĞLU M Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. . 2009; 331 - 337.
Vancouver	SEZER A,İRFANOĞLU M Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. . 2009; 331 - 337.
IEEE	SEZER A,İRFANOĞLU M "Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases." , ss.331 - 337, 2009.
ISNAD	SEZER, Atakan - İRFANOĞLU, Mehmet Emin. "Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases". (2009), 331-337.

APA	SEZER A, İRFANOĞLU M (2009). Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. Trakya Üniversitesi Tıp Fakültesi Dergisi, 26(4), 331 - 337.
Chicago	SEZER Atakan,İRFANOĞLU Mehmet Emin Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. Trakya Üniversitesi Tıp Fakültesi Dergisi 26, no.4 (2009): 331 - 337.
MLA	SEZER Atakan,İRFANOĞLU Mehmet Emin Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. Trakya Üniversitesi Tıp Fakültesi Dergisi, vol.26, no.4, 2009, ss.331 - 337.
AMA	SEZER A,İRFANOĞLU M Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. Trakya Üniversitesi Tıp Fakültesi Dergisi. 2009; 26(4): 331 - 337.
Vancouver	SEZER A,İRFANOĞLU M Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases. Trakya Üniversitesi Tıp Fakültesi Dergisi. 2009; 26(4): 331 - 337.
IEEE	SEZER A,İRFANOĞLU M "Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases." Trakya Üniversitesi Tıp Fakültesi Dergisi, 26, ss.331 - 337, 2009.
ISNAD	SEZER, Atakan - İRFANOĞLU, Mehmet Emin. "Surgical management of secondary hyperparathyroidism in patients with end-stage renal disease: Surgical approaches and report of cases". Trakya Üniversitesi Tıp Fakültesi Dergisi 26/4 (2009), 331-337.