Intramuscular and subcutaneous forearm parathyroid autotransplantation after total parathyroidectomy for renal hyperparathyroidism patients

Objective To compare the effects of intramuscular or subcutaneous forearm parathyroid autotransplantation after total parathyroidectomy on patients with renal hyperparathyroidism. Methods From Jan.2012 to Dec.2013, total parathyroidectomy was carried out in 90 patients with renal hyperparathyroidism. According to the location of their parathyroid autograft, patients were divided into intramuscular group(n=39)and subcutaneous group(n=51). One patient in the intramuscular group and two in the subcutaneous group were excluded for the high levels of intact parathyroid hormone(iPTH)the day after operation. iPHT was analyzed 2 weeks, 1 month, 3 and 6 months after surgery. Results The time of autotransplantation was significantly shorter in subcutaneous group than in intramuscular group(11.46(2.63)min vs 22.12(3.78)min; t=0.632, P<0.05). iPTH levels were significantly lower in subcutaneous group than in intramuscular group 2 weeks after operation (P<0.05). There was no significant difference between the 2 groups regarding iPTH levels at 1 month, 3 or 6 months after surgery. In the follow-up one patient in intramuscular group and one in subcutaneous group had graft-dependent hyperparathyroidism. Conclusion As compared to intramuscular parathyroid autotransplantation, subcutaneous parathyroid autotransplantation has advantages of simpler to operate, shorter autoimplantation time and easier to autograftectomy. Key words: Renal failure; Renal hyperparathyroidism; Total parathyroidectomy; Autoimplantation