Results after 223 parathyroidectomies for secondary hyperparathyroidism

Background: Authors describe their experience in surgical treatment of secondary HPT considering the alternative between subtotal and total PTx with AT. Methods: 223 patients were operated on for secondary HPT. 154 subtotal PTx were carried out, 32 total PTx with AT, 26 total and only 3 glands removed in 12. Results: Results after 230 PTx seems to favour subtotal PTx because is a shorter and easier operation. Total PTx with AT is indicated in the presence of goiter, large or ectopic glands, in case of reoperation. The possibility of freezing some parathyroid fragments is the condition for total PTx with AT. In any case having assessed all our results we feel that the surgeon's personal experience and preferences may well be decisive since neither operation is intrinsically better than the other. Conclusions: All these type of operations considered, vascular calcification do not improve, normocalcemia is obtained in 24, 48 hours, ectopic calcification disappear in 1 year and osteodystrophy in 6-12 months.