Endocrine Abstracts

JOINT3714

Objectives: Identify the indications for parathyroidectomy (PTX) in secondary hyperparathyroidism (SHPT), report postoperative evolution, and describe early and late complications of PTX.

Materials and Methods: We carried out a retrospective study on patients with chronic renal failure who underwent parathyroidectomy (PTX) in our ENT department over a 13-year period, from January 2010 to December 2023. Clinical, biological, and radiological parameters were analyzed both preoperatively and postoperatively.

Results: Our study included a total of 70 patients with a mean age of 41 years. The median preoperative PTH and calcium levels were 1680 pg/mL [368,3742] and 2.2 mmol/l, respectively. The main clinical manifestation in our series was bone pain. In our study, 66 patients (94.28%) underwent cervical ultrasound, whereas parathyroid scintigraphy was performed in all cases. Cervicothoracic computed tomography was performed in only three patients (8.57%) to investigate ectopic parathyroid glands. No patient underwent magnetic resonance imaging (MRI). Surgical treatment consisted of subtotal parathyroidectomy in 66 patients, either 7/8th (n = 56) or 3/4th (n = 10). Three patients underwent total parathyroidectomy. The final histopathological examination revealed hyperplasia of the resected parathyroid glands in all patients. The cure rate was 78.57%. Persistent hyperparathyroidism was observed in 15 patients, including two cases associated with vitamin D deficiency. Three cases of recurrence were noted in our series.

Conclusion: Secondary hyperparathyroidism is a common and serious complication of chronic renal failure. Surgery is the treatment of choice when medical therapy fails.