ArticleBMC endocrine disorders2026
Total parathyroidectomy versus total parathyroidectomy with autotransplantation for refractory secondary hyperparathyroidism: short-term biochemical outcomes and postoperative calcium supplementation burden.
Article in BMC endocrine disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundComparative 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).
methodsWe 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.
resultsBoth 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.
conclusionsTPTX 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.
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