<Originals>Evaluation of indications for subtotal parathyroidectomy in secondary hyperparathyroidism

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Between January, 1980,and March, 1990,subtotal parathyroidectomy was performed on 31 patients with secondary hyperparathyroidism (SHP). Therapeutic effects were evaluated by improvement in ostalgia and arthralgia more than 1 month after surgery. Twenty patinets showed complete (8 patients) or partial improvement (12 patinets), and were classified as the improved group. The non-improved group consisted of 10 showing change and 1 showing progressive disease. No significant differences were obserevd between the improved and non-improved groups regarding sex distribution or preoperative dialysis periods, nor was any significant difference were observed between the resected gland weights of the two groups. In both the improved and the non-improved groups, serum calcium decreased after surgery (P<0.05). In the non-improved group, serum phosphate and serum alkaline phosphatase (ALP) decreased after surgery (P<0.05). No significant difference between preoperative and postoperative serum PTH values was observed in either group. Furthermore, no significant difference was observed between the two groups in either preoperative or postoperative serum PTH values. In those patients with preoperative findings of fibrous osteitis, symptoms (e.g. ostalgia, arthralgia) improved significantly after surgery (p<0.05). It is usually accepted that parathyroid resection of less than 1.0 g is not effective ; however, our results revealed that this was not so, that a parathyroid resection of less than 1.0 g was indeed effective.
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<Originals>Evaluation of indications for subtotal parathyroidectomy in secondary hyperparathyroidism

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