To Campare The Clinical Effect Between Endoscopic And Open Total Parathyroidectomy+Parathyroid Tissue Autotransplantation In Treating Secondary Hyperparathyroidism

Objective: To campare the clinical effect between endoscopic totalparathyroidectomy(ETP) with parathyroid tissue autotransplantation (PTA) and openparathyroidectomy (OP) with PTA in treating secondary hyperparathyroidism (SHPT).Methods:22SHPT patients were treated with the endoscopic thyroidectomy via anteriorthoracic approach approachand implanted with16parts of proliferating parathyroidgland with the size1mm*1mm*3mm under the brachioradialis muscle membrane side, theanother25SHPT patients were treated with OP+PTA via neck from April2009-June2012.Results:The22ETP+PTA and25OP+PTA operations were carried out successfullyand nodie during perioperative period. In group ETA, the average operation time was125.8min (85-155min), the average amount of bleeding was30.5ml (10-50M1), groupOP, the average operation time was175.6min (125-202min), the average amount ofbleeding was40.2ml (20-65M1). ETA group out of bed time averaged1D (0.5-1.5d), the average hospitalization was10d (7-15d). OP group out of bed time averaged1.7D (1-2.1d), the average hospitalization was11.5D (8-16D).Studies have shown thatETP operation time and OP without significantly prolonged (p<0.05), the amount ofbleeding, hospitalization time, bed time was lower than that of OP group, easy tofind parathyroid,Intraoperative, postoperative complications were less than OP, while no significantdifference in clinical efficacy, clinical symptoms significantly improved afteroperation, biochemical examination were normal or improved,follow-up recurrence sixmonths there was no significant difference. Conclusions: ETP+PTA treatment for SHPT than PTX+PTA treatment of SHPT hascertain advantages, its therapeutic effect is better, more easily findthe parathyroid,and small trauma, quick recovery, is worthy of promotion.