Surgical Treatment of Secondary Hyperparathyroidism in Surgery B of Chu of Point G
- 1 Service of Surgery B, CHU Point G, Bamako, Mali
- 2 Service of Surgery A, CHU Point G, Bamako, Mali
- 3 Service of Surgery A, CHU Point G, Bamako, Mali
- 4 Laboratory of Anatomy, Faculty of Medicine and Odontostomatology, Bamako, Mali
- 5 Service of Surgery B, CHU Point G, Bamako, Mali
- 6 Service of Surgery A, CHU Point G, Bamako, Mali
- 7 Service of Surgery B, CHU Point G, Bamako, Mali
- 8 Service of Surgery A, CHU Point G, Bamako, Mali
- 9 Service of Surgery B, CHU Point G, Bamako, Mali
- 10 Service of Surgery B, CHU Point G, Bamako, Mali
Abstract
Purpose : To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods : We collected 11 cases of hyperparathyroidism secondary to renal failure terminal operated in the Service of surgery B of the Central Hospital University of Point G between December 2016 and November 2018. Results : The sex ratio was 0.22 in favor of women. The average age of the patients was 43 or 27 years with extremes of 63 and 25 years. Secondary hyperparathyroidism in renal failure chronic represented 1.9% of interventions to cold in the Service of surgery B. 100% of patients (11/11) were haemodialysis. 100% of the patients had clinical and biological signs. 45.5% (5/11) had radiological signs. The average rate of parathyroid hormone was 2413.51 pg/ml with extremes of 1264 pg/ml and 3616 pg/ml. The reference value was 15 - 65 pg/ml. The surgical technique of choice was the 7/8th parathyroidectomy in 100% of cases. The postoperative were simple in 81.8%, and complicated in 18.2%. There were no death. The average duration of postoperative follow-up was 6 months. After surgery, 50% of patients (5/10) had normal levels of parathyroid hormone and 50% (5/10) made a persistent hyperparathyroidism. Conclusion : Secondary hyperparathyroidism is a frequent complication in renal insufficient chronic in hemodialysis. Surgery is indicated in the resistant cases of medical treatment. The 7/8th parathyroidectomy is the surgical technique of choice. The rate of post operative complications is higher in our context.
- Lamyae, E. (2016) Traitement chirurgical de l’hyperparathyroidie scondaire chez l’hémodialysé chronique (A propos de 7cas). Thèse Med. Maroc, Nº052/16.
- Sayad, H, Rifki Jai, S., Lakhloufi, A., Chihad, F., Bouzidi, A., Aghai, R., Tarras, F., Ramdani, B., Hachim, R., Benghanem, N.G., Zaid, D. and Ahazzam, J. (2008) Traitement chirurgical de l’hyperparathyroidie secondaire des insuffisants rénaux: A propos de 57 cas. La Tunisie Médicale, 86, 140-143.
- Konturek, A., Barczyński, M., Stopa, M. and Nowak, W. (2016) Subtotal Parathyroidectomie for Secondary Renalhyperthyroidism: A 20-Year Surgical Outcome Study. Langenbeck’s Archives of Surgery, 401, 965-974. https://doi.org/10.1007/s00423-016-1447-7
- Murray, S.E., Sippel, R.S. and Chen, H. (2012) The Incidence of Concomitant Hyperparathyroidism in Patient with Thyroid Disease Requiring Surgery. Journal of Surgical Research, 178, 264-267. https://doi.org/10.1016/j.jss.2012.03.008
- Magali, F. (2005) Prise en charge chirurgicale de l’hyperparathyroidie secondaire dans l’insuffisance rénale chronique: à propos de 230Tcas. Thèse Med France, Nº10.
- Tsung-Liang, M.A., et al. (2015) Parathyroidectomy Is Associated with Reduced Mortality in Hemodialysis Patients with Secondary Hyperparathyroidism. BioMed Research International, 2015, Article ID: 639587.