Akın Önder, Murat Kapan, Sadullah Girgin, İbrahim Aliosmanoğlu, Mesut Gül, Fatih Taşkesen, Zülfü Arıkanoğlu, Ömer Başol
Keywords: Secondary hyperparathyroidism, parathyroidectomy, sedation and local anesthesia.
Aim: Secondary hyperparathyroidism due to end stage renal failure is a serious complication. In this study, we aimed to investigate the technical features, pathologic findings and follow-up outcomes of parathyroidectomy under sedation with local anesthesia in patients with secondary hyperparathyroidism localized in one lobe.
Material and Methods: The records of 10 secondary hyperparathyroidism diagnosed patients who undergone to parathyroidectomy under sedation with local anesthesia were retrospectively evaluated between 2007 to 2011.
Results: Male to female ratio was 3/7, and the mean age was 48.5±10.8 (30-62) years. The most common localization of the pathology was the right inferior lobe (40%). The most common clinical finding is muscle weakness (90%). Preoperative laboratory tests revealed higher levels of parathormon, calcium, phosphor, and alkaline phosphates. 24 hours after surgery, parathormon levels were normal, except 1 patient. Hypocalcamia developed in 7 patients (70%) after surgery. In all patients parathyroid pathology was detected with ultrasonography and parathyroid sintigraphy. The mean operation time was 25.3 ±12.5 (15-39) minutes. The mean hospitalization time was 1.1 ±0.3(1-2) days. Hematoma due to hemorrhage was occured in 1 patient, and successfully drained. None of the patients developed recurrence nerve injury. The median follow-up time was 17(4-48)month. Recurrence was observed in two patients in the follow-up period.
Conclusion: parathyroidectomy under sedation with local anesthesia is a safe, less traumatic intervention, and shortens the hospitalization time in the treatment of the secondary hyperparathyroid adenomas localized in one lobe.