Application of Endoscopic Total Parathyroidectomy with Autotransplantation in the Treatment of Secondary Hyperparathyroidism in Chronic Renal Failure

Objective To study the clinical efficacy of endoscopic total parathyroidectomy with autotransplantation (ETPTX + AT) in the treatment of secondary hyperparathyroidism (SHPT) in chronic renal failure. Methods A total of 433 patients who underwent ETPTX + AT in our hospital from March 2019 to March 2024 were collected. The intraoperative conditions, postoperative complications, and changes in preoperative and postoperative biochemical indicators were observed by comparing the preoperative and postoperative serum calcium, serum phosphorus, and parathyroid hormone (PTH) levels of the patients. Results Among the patients, 412 (95.2%) had postoperative PTH < 100 pg/ml. The postoperative PTH, serum calcium, and serum phosphorus of the patients were significantly lower than those before surgery, and the differences were statistically significant (P < 0.05). During the perioperative period, 1 patient (0.23%) died of cardiac insufficiency, 4 patients (0.9%) had transient recurrent laryngeal nerve injury, 69 patients (15.9%) developed postoperative hypocalcemia (< 2.1 mmol/L), 1 patient (0.23%) was converted to open surgery, 7 patients (1.6%) had upper extremity vascular fistula occlusion after surgery, and 1 patient (0.23%) had cervical hematoma. Conclusion ETPTX is a very effective method for the treatment of SHPT, which can significantly reduce the patient's PTH, serum calcium, and serum phosphorus levels.