Role of thymectomy in surgical treatment of renal hyperparathyroidism.

Autor: Guo MY; Department of General Surgery, University of British Columbia, Canada., Pillar M; Faculty of Medicine, University of British Columbia, Canada., Manhas N; Department of General Surgery, University of British Columbia, Canada., Melck A; Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada. Electronic address: amelck@providencehealth.bc.ca.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Nov; Vol. 237, pp. 115864. Date of Electronic Publication: 2024 Jul 27.
DOI: 10.1016/j.amjsurg.2024.115864
Abstrakt: Introduction: The role for routine thymectomy in patients with secondary or tertiary hyperparathyroidism (SHPT, THPT) is unclear. We aim to compare rates of recurrence and complications in patients who underwent subtotal parathyroidectomy with and without thymectomy.
Methods: Patients who underwent surgery for renal HPT at a tertiary endocrine surgery center between 2010 and 2022 were reviewed. Presence of parathyroid tissue in resected tissue was identified through pathology reports. A multivariate logistic regression was used to compare baseline characteristics, recurrence rates and complications between those who did and did not undergo thymectomy.
Results: Of 107 patients who underwent subtotal parathyroidectomy, 29 (27.1 ​%) underwent concomitant thymectomy. Recurrence occurred in 15 patients (14 ​%). Thymectomy did not affect recurrence (OR: 0.33, 95%CI: 0.06-1.28, p ​= ​0.14), but was associated with permanent hypoparathyroidism (OR: 4.62, 95%CI: 1.67-13.18, p ​= ​0.003). Fewer parathyroid specimens increased the odds of thymectomy (p ​= ​0.04). Parathyroid glands were found in 6 thymectomy samples (20.7 ​%).
Conclusion: Thymectomy at the time of subtotal parathyroidectomy for renal HPT was not associated with disease recurrence, but increased likelihood of permanent hypoparathyroidism.
(Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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