Abstract: 【Abstract】Objective To compare the efficacy of subtotal parathyroidectomy and less-than subtotal parathyroidectomy in uremic patients with secondary hyperparathyroidism (SHPT). Methods We retrospectively analyzed 18 patients subjected to parathyroidectomy in this hospital from July 2007 to May 2011. The patients were assigned into two groups: less-than subtotal parathyroidectomy group (n=8), in which 3 of the 4 glands were resected, and subtotal parathyroidectomy group (n=10), in which 3 and a half of the 4 glands were removed. Serum calcium (Ca), phosphorus (P), calcium-phosphorus product (Ca×P), intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP), as well as changes of clinical symptoms and related complications were observed before operation and after the operation for one day, one week, one month and 6 months. Results No statistical differences were found in number of parathyroid nodules, serum Ca, P, Ca×P, iPTH and ALP before operation between the two groups. There were statistical differences in Ca, P, Ca×P, iPTH and ALP before and after operation in each group (P＜0.05). In subtotal parathyroidectomy group, serum Ca was lower after operation for one week and one month (P＜0.05), P and Ca×P were lower after operation for one week, one month and six months, iPTH was lower after operation for one day, one week, one month and six months, while ALP was lower after operation for six months, as compared with those of the less-than subtotal parathyroidectomy group. In both groups, pain symptoms relieved after operation for one week, without differences in relief time and operation complications between the two groups.  Conclusion Subtotal parathyroidectomy is more effective than less-than subtotal parathyroidectomy for the treatment of persistent/recurrent hyperparathyroidism.

Key words: Subtotal parathyroidectomy, Secondary hyperparathyroidism, Maintenance hemodialysis, Persistent/recurrent hyperparathyroidism