Abstract
Introduction: Reducing serum parathyroid hormone (PTH) level in patients with chronic renal failure can be achieved either by medical treatment or by parathyroidectomy. However, the long-term outcome of parathyroidectomy is better. More than one surgical technique can be done and there is no consensus about the best technique.
Objectives: In this study, we present our results in different techniques for parathyroidectomy for these children.
Patients and Methods: Six patients of both sexes with chronic renal failure and secondary hyperparathyroidism were collected from pediatric surgery department, Ain Shams University in the period between October 2014 and October 2015. All these patients underwent parathyroidectomy (Subtotal with preservation of half a gland in three patients, Subtotal with preservation of a whole gland in two patients and total with auto-transplantation in one patient). Patients were followed up for serum PTH and calcium levels to detect recurrence of hyperparathyroidism.
Results: Serum PTH and calcium levels dropped to normal levels after three months, in 3 of 6 patients (one with preservation of half of a gland, one with preservation of a whole gland and one with total parathyroidectomy and auto-transplantation). Two patients developed hypercalcemia and increased PTH level (one with preservation of half of a gland and the other with preservation of a whole gland). The sixth patient died one month postoperatively (the one with preservation of half of a gland).
Conclusion: There is no consensus upon the preferred surgical technique of parathyroidectomy in children with chronic renal failure and secondary hyperparathyroidism.