Secondary Hyperparathyroidism
Keywords:
Secondary hyperparathyroidism, Subtotal parathyroidectomy, Total parathyroidectomy with autotransplantation, Missing parathyroid glandAbstract
Secondary hyperparathyroidism (SHPT) is the most commonly found major complication of chronic kidney disease (CKD) with a prevalence of 12-54%. The stimulation of parathyroid hormone production as a result of hyperphosphatemia and hypocalcemia affects different organ systems in the body. The main options of treatment are medication and surgery by which consists of subtotal parathyroidectomy and total parathyroidectomy with autotransplantation. In cases with missing parathyroid gland during surgery, intraoperative systematic searching is a preferred way to approach. However, if the parathyroid gland remains missing, the surgery may need to be postponed and two imaging modalities are then required before going on a second operation. Using the right techniques and understanding of the surgical anatomy of the parathyroid gland helps to decrease the rate of complication, mortality and improves overall quality of life in patients.
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