Abstract：
BACKGROUND: Total parathyroidectomy with autotransplantation is still an excellent treatment option for secondary hyperparathyroidism. Intramuscular or subcutaneous parathyroid autotransplantation has been previously reported; however, there have been no studies to date regarding the implantation of the parathyroid tissue in the subclavian area of the neck.
METHODS: This was a prospective cross-sectional study between 2018 and 2019. Patients who underwent total parathyroidectomy with autotransplantation of parathyroid tissue into subcutaneous subclavicular area due to secondary hyperparathyroidism were included. The patients\' demographic information, including age and gender, was gathered, and the length of the dialysis period was asked from the patients. To evaluate the outcome of the study, parathyroid hormone (PTH) was measured and recorded before and after the operation. SPSS software, version 26, was used for data analysis.
RESULTS: Forty-two patients with a mean age of 41.05 ± 9.41 years were included. The mean length of the dialysis period was 8.07 ± 2.68 years. The mean primary PTH was 1770.61 ± 482.97 pg/ml (range: 656-2500 <). After 6 weeks of operation, 19 patients (45.2%) had functional autotransplanted tissue, and the median PTH was 28 pg/ml (IQR: 33.55, range: 0.1-221.8). However, the results showed that after 10 weeks, the patients with functional tissue were increased to 22 (52.4%), and the median PTH was 35 pg/ml (IQR: 48, range: 5.0-602.9). The functionality of autotransplanted tissue in the 6th and 10th weeks after surgery had no significant association with age, gender, and length of the dialysis period (p value > 0.05).
CONCLUSIONS: Subcutaneous implantation is recommended in the treatment of secondary hyperparathyroidism based on its high success rate and ease of use, suitable vascularization, easy accessibility to the surgery location in case of the need for autographtectomy.
METHODS: This was a prospective cross-sectional study between 2018 and 2019. Patients who underwent total parathyroidectomy with autotransplantation of parathyroid tissue into subcutaneous subclavicular area due to secondary hyperparathyroidism were included. The patients\' demographic information, including age and gender, was gathered, and the length of the dialysis period was asked from the patients. To evaluate the outcome of the study, parathyroid hormone (PTH) was measured and recorded before and after the operation. SPSS software, version 26, was used for data analysis.
RESULTS: Forty-two patients with a mean age of 41.05 ± 9.41 years were included. The mean length of the dialysis period was 8.07 ± 2.68 years. The mean primary PTH was 1770.61 ± 482.97 pg/ml (range: 656-2500 <). After 6 weeks of operation, 19 patients (45.2%) had functional autotransplanted tissue, and the median PTH was 28 pg/ml (IQR: 33.55, range: 0.1-221.8). However, the results showed that after 10 weeks, the patients with functional tissue were increased to 22 (52.4%), and the median PTH was 35 pg/ml (IQR: 48, range: 5.0-602.9). The functionality of autotransplanted tissue in the 6th and 10th weeks after surgery had no significant association with age, gender, and length of the dialysis period (p value > 0.05).
CONCLUSIONS: Subcutaneous implantation is recommended in the treatment of secondary hyperparathyroidism based on its high success rate and ease of use, suitable vascularization, easy accessibility to the surgery location in case of the need for autographtectomy.
摘要：
背景：甲状旁腺全切除术联合自体移植仍然是继发性甲状旁腺功能亢进的一种很好的治疗选择。以前曾报道过肌内或皮下甲状旁腺自体移植；然而，迄今为止,还没有关于在颈部锁骨下区域植入甲状旁腺组织的研究.
方法：这是一项2018年至2019年的前瞻性横断面研究。包括因继发性甲状旁腺功能亢进而接受全甲状旁腺切除术并将甲状旁腺组织自体移植到皮下锁骨下区域的患者。患者的人口统计信息，包括年龄和性别,聚集在一起，并询问患者透析期的长短。为了评估研究结果，术前、术后测量并记录甲状旁腺激素(PTH)。SPSS软件,版本26，用于数据分析。
结果：纳入42例患者，平均年龄为41.05±9.41岁。透析期的平均长度为8.07±2.68年。平均原发性PTH为1770.61±482.97pg/ml（范围：656-2500<）。手术6周后,19例患者（45.2%）有功能性自体移植组织，PTH中位数为28pg/ml（IQR：33.55，范围：0.1-221.8）。然而,结果显示，10周后，有功能组织的患者增加到22例（52.4%），PTH中位数为35pg/ml（IQR：48，范围：5.0-602.9）。术后第6周和第10周自体移植组织的功能与年龄无显著相关性,性别,和透析期的长度（p值>0.05）。
结论：皮下植入治疗继发性甲状旁腺功能亢进的成功率高，使用方便，推荐使用皮下植入。合适的血管化，在需要自体子宫切除术的情况下，容易接近手术位置。
方法：这是一项2018年至2019年的前瞻性横断面研究。包括因继发性甲状旁腺功能亢进而接受全甲状旁腺切除术并将甲状旁腺组织自体移植到皮下锁骨下区域的患者。患者的人口统计信息，包括年龄和性别,聚集在一起，并询问患者透析期的长短。为了评估研究结果，术前、术后测量并记录甲状旁腺激素(PTH)。SPSS软件,版本26，用于数据分析。
结果：纳入42例患者，平均年龄为41.05±9.41岁。透析期的平均长度为8.07±2.68年。平均原发性PTH为1770.61±482.97pg/ml（范围：656-2500<）。手术6周后,19例患者（45.2%）有功能性自体移植组织，PTH中位数为28pg/ml（IQR：33.55，范围：0.1-221.8）。然而,结果显示，10周后，有功能组织的患者增加到22例（52.4%），PTH中位数为35pg/ml（IQR：48，范围：5.0-602.9）。术后第6周和第10周自体移植组织的功能与年龄无显著相关性,性别,和透析期的长度（p值>0.05）。
结论：皮下植入治疗继发性甲状旁腺功能亢进的成功率高，使用方便，推荐使用皮下植入。合适的血管化，在需要自体子宫切除术的情况下，容易接近手术位置。
