Total parathyroidectomy versus total parathyroidectomy with autotransplantation for refractory secondary hyperparathyroidism: short-term biochemical outcomes and postoperative calcium supplementation burden
- 1Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
Abstract
Background Comparative studies of total parathyroidectomy (TPTX) and total parathyroidectomy with autotransplantation (TPTX + AT) have primarily emphasized biochemical control and recurrence, whereas longitudinal outpatient oral calcium requirements have been less frequently quantified. This study compared short-term biochemical outcomes and postoperative calcium supplementation burden after these two procedures for refractory secondary hyperparathyroidism (SHPT). Methods We retrospectively analyzed a nonrandomized cohort of 80 patients with refractory SHPT who underwent parathyroidectomy between January and December 2021 (TPTX, n = 40; TPTX + AT, n = 40). Biochemical markers were evaluated preoperatively and at postoperative day 3 and at postoperative months 1, 3, and 6. The practical postoperative outcome was prescribed oral calcium carbonate burden (500-mg tablets/day) at discharge and at 3 and 6 months. Acute intravenous calcium use and calcitriol supplementation were also recorded. Results Both groups achieved satisfactory short-term biochemical control without major perioperative complications. Operative time was longer in the TPTX + AT group (p = 0.015). Compared with the TPTX + AT group, the TPTX group had higher serum calcium at 3 and 6 months, lower phosphate at 1 and 3 months, and lower bone-specific alkaline phosphatase and intact parathyroid hormone at 3 and 6 months. Despite these biochemical differences, acute intravenous calcium use and outpatient oral calcium and calcitriol supplementation did not differ significantly between groups. Conclusions TPTX and TPTX + AT yielded satisfactory short-term biochemical outcomes. TPTX + AT was associated with higher postoperative intact parathyroid hormone levels, compatible with greater postoperative parathyroid activity; however, no significant between-group difference in prescribed oral calcium or calcitriol supplementation burden through 6 months was detected. Because procedure allocation was nonrandomized, thymectomy practices differed, and follow-up was limited to 6 months, these findings are descriptive and do not establish procedural superiority or long-term recurrence risk.
Related
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BibTeX
@article{see2026total,
title = {{Total parathyroidectomy versus total parathyroidectomy with autotransplantation for refractory secondary hyperparathyroidism: short-term biochemical outcomes and postoperative calcium supplementation burden}},
author = {Horng-Shiuan See and Kian-Hwee Chong and Yu-Tien Chen and Jia-Hui Chen and Chieh-Wen Lai},
journal = {BMC Endocrine Disorders},
year = {2026},
month = jul,
doi = {10.1186/s12902-026-02430-8},
url = {https://doi.org/10.1186/s12902-026-02430-8},
note = {CC BY},
}
RIS
TY - JOUR
TI - Total parathyroidectomy versus total parathyroidectomy with autotransplantation for refractory secondary hyperparathyroidism: short-term biochemical outcomes and postoperative calcium supplementation burden
AU - Horng-Shiuan See
AU - Kian-Hwee Chong
AU - Yu-Tien Chen
AU - Jia-Hui Chen
AU - Chieh-Wen Lai
PY - 2026
DA - 2026/07/01
JO - BMC Endocrine Disorders
DO - 10.1186/s12902-026-02430-8
UR - https://doi.org/10.1186/s12902-026-02430-8
AB - Background Comparative studies of total parathyroidectomy (TPTX) and total parathyroidectomy with autotransplantation (TPTX + AT) have primarily emphasized biochemical control and recurrence, whereas longitudinal outpatient oral calcium requirements have been less frequently quantified. This study compared short-term biochemical outcomes and postoperative calcium supplementation burden after these two procedures for refractory secondary hyperparathyroidism (SHPT). Methods We retrospectively analyzed a nonrandomized cohort of 80 patients with refractory SHPT who underwent parathyroidectomy between January and December 2021 (TPTX, n = 40; TPTX + AT, n = 40). Biochemical markers were evaluated preoperatively and at postoperative day 3 and at postoperative months 1, 3, and 6. The practical postoperative outcome was prescribed oral calcium carbonate burden (500-mg tablets/day) at discharge and at 3 and 6 months. Acute intravenous calcium use and calcitriol supplementation were also recorded. Results Both groups achieved satisfactory short-term biochemical control without major perioperative complications. Operative time was longer in the TPTX + AT group (p = 0.015). Compared with the TPTX + AT group, the TPTX group had higher serum calcium at 3 and 6 months, lower phosphate at 1 and 3 months, and lower bone-specific alkaline phosphatase and intact parathyroid hormone at 3 and 6 months. Despite these biochemical differences, acute intravenous calcium use and outpatient oral calcium and calcitriol supplementation did not differ significantly between groups. Conclusions TPTX and TPTX + AT yielded satisfactory short-term biochemical outcomes. TPTX + AT was associated with higher postoperative intact parathyroid hormone levels, compatible with greater postoperative parathyroid activity; however, no significant between-group difference in prescribed oral calcium or calcitriol supplementation burden through 6 months was detected. Because procedure allocation was nonrandomized, thymectomy practices differed, and follow-up was limited to 6 months, these findings are descriptive and do not establish procedural superiority or long-term recurrence risk.
SN - 1472-6823
ER -