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Subtotal vs. total parathyroidectomy with autotransplantation for patients with renal hyperparathyroidism have similar outcomes.

Publication ,  Journal Article
Anderson, K; Ruel, E; Adam, MA; Thomas, S; Youngwirth, L; Stang, MT; Scheri, RP; Roman, SA; Sosa, JA
Published in: American journal of surgery
November 2017

The optimal surgery for patients with renal hyperparathyroidism has been controversial, as either subtotal parathyroidectomy (subtotal PTX) or total parathyroidectomy with auto-transplantation (total PTX-AT) may be employed.Adult patients having subtotal PTX or total PTX-AT for secondary hyperparathyroidism were identified from the American College of Surgeons National Surgical Quality Improvement Program, 2005-2013.Of 1130 patients, the majority (n = 765, 68%) underwent subtotal PTX. Total PTX-AT was associated with longer operative time (median 150 vs. 120 min, p < 0.001). Rates of complications, reoperation, readmission, and 30-day mortality were not significantly different. After adjustment, the odds of having a complication [OR 0.97, p = 0.88] and being readmitted within 30 days [OR 0.86 p = 0.62] were similar between the two procedures. Total PTX-AT was associated with prolonged hospital stay [Adjusted mean 5.0 vs. 4.1 days; (RR) 1.22, p < 0.001] compared to subtotal PTX.Subtotal PTX and total PTX-AT have similar rates of complications, readmission, and 30-day mortality, but subtotal PTX is less likely to have extended hospital stay. These findings have important cost implications for patients, payers, and hospitals.

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Published In

American journal of surgery

DOI

EISSN

1879-1883

ISSN

0002-9610

Publication Date

November 2017

Volume

214

Issue

5

Start / End Page

914 / 919

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Surgery
  • Parathyroidectomy
  • Parathyroid Glands
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Hyperparathyroidism, Secondary
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Anderson, K., Ruel, E., Adam, M. A., Thomas, S., Youngwirth, L., Stang, M. T., … Sosa, J. A. (2017). Subtotal vs. total parathyroidectomy with autotransplantation for patients with renal hyperparathyroidism have similar outcomes. American Journal of Surgery, 214(5), 914–919. https://doi.org/10.1016/j.amjsurg.2017.07.018
Anderson, Kevin, Ewa Ruel, Mohamed A. Adam, Samantha Thomas, Linda Youngwirth, Michael T. Stang, Randall P. Scheri, Sanziana A. Roman, and Julie A. Sosa. “Subtotal vs. total parathyroidectomy with autotransplantation for patients with renal hyperparathyroidism have similar outcomes.American Journal of Surgery 214, no. 5 (November 2017): 914–19. https://doi.org/10.1016/j.amjsurg.2017.07.018.
Anderson K, Ruel E, Adam MA, Thomas S, Youngwirth L, Stang MT, et al. Subtotal vs. total parathyroidectomy with autotransplantation for patients with renal hyperparathyroidism have similar outcomes. American journal of surgery. 2017 Nov;214(5):914–9.
Anderson, Kevin, et al. “Subtotal vs. total parathyroidectomy with autotransplantation for patients with renal hyperparathyroidism have similar outcomes.American Journal of Surgery, vol. 214, no. 5, Nov. 2017, pp. 914–19. Epmc, doi:10.1016/j.amjsurg.2017.07.018.
Anderson K, Ruel E, Adam MA, Thomas S, Youngwirth L, Stang MT, Scheri RP, Roman SA, Sosa JA. Subtotal vs. total parathyroidectomy with autotransplantation for patients with renal hyperparathyroidism have similar outcomes. American journal of surgery. 2017 Nov;214(5):914–919.
Journal cover image

Published In

American journal of surgery

DOI

EISSN

1879-1883

ISSN

0002-9610

Publication Date

November 2017

Volume

214

Issue

5

Start / End Page

914 / 919

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Surgery
  • Parathyroidectomy
  • Parathyroid Glands
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Hyperparathyroidism, Secondary
  • Humans