{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:44:41Z","timestamp":1788864281294,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T00:00:00Z","timestamp":1531094400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Endocrinology"],"published-print":{"date-parts":[[2018,7,9]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>. Secondary hyperparathyroidism is common in chronic kidney disease. Parathyroidectomy is indicated in refractory hyperparathyroidism when medical treatments and so the parathyroid hormone levels cannot be lowered to acceptable values without causing significant hyperphosphatemia or hypercalcemia. The aim of this study is to compare the efficacy and safety of total parathyroidectomy with subcutaneous forearm autotransplantation with total parathyroidectomy with intramuscular forearm autotransplantation.<jats:italic>Materials and Methods<\/jats:italic>. A single-center retrospective cohort study of total parathyroidectomy with forearm autotransplantation from January 2002 to February 2013 was performed. According to the surgical technique, patients were divided into an intramuscular group (Group 1) and a subcutaneous group (Group 2). 38 patients with secondary hyperparathyroidism were enrolled; 23 patients were subjected to total parathyroidectomy with parathyroid tissue replanting in the subcutaneous forearm of the upper nondominant limb, while 15 patients were subjected to replanting in the intramuscular seat.<jats:italic>Results<\/jats:italic>. A total of 38 patients (56\u2009\u00b1\u200913 years) were enrolled. In both groups, the preoperative iPTH value was markedly high, 1750\u2009\u00b1\u2009619\u2009pg\/ml in the intramuscular autotransplantation group and 1527\u2009\u00b1\u2009451\u2009pg\/ml in the subcutaneous autotransplantation group (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontfamily=\"Liberation Serif\">0.079<\/mml:mn><\/mml:math>). Transient hypoparathyroidism was shown in 7 patients, and 1 patient showed persistent hypoparathyroidism (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontfamily=\"Liberation Serif\">0.387<\/mml:mn><\/mml:math>). 2 patients showed persistent hyperparathyroidism (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontfamily=\"Liberation Serif\">0.816<\/mml:mn><\/mml:math>), and in 2 others was found recurrent hyperparathyroidism (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontfamily=\"Liberation Serif\">0.816<\/mml:mn><\/mml:math>); 3 of them underwent autograftectomy. The anterior compartment of the forearm nondominant limb was sacrificed in 1 case of intramuscular autotransplantation with functional arm deficit.<jats:italic>Conclusions<\/jats:italic>. The efficacy and safety of parathyroid tissue autotransplantation in the subcutaneous forearm of the upper nondominant limb is confirmed with a good rate of tissue engraftment and with a comparable number of postsurgical transient and persistent hypoparathyroidism and hyperparathyroidism incidence in both techniques. Furthermore, this technique preserves arm functionality in the case of autograftectomy. Consequently, it is our opinion that total parathyroidectomy with subcutaneous forearm autotransplantation is currently the best choice.<\/jats:p>","DOI":"10.1155\/2018\/6065720","type":"journal-article","created":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T23:33:29Z","timestamp":1531179209000},"page":"1-7","source":"Crossref","is-referenced-by-count":14,"title":["Total Parathyroidectomy with Subcutaneous Parathyroid Forearm Autotransplantation in the Treatment of Secondary Hyperparathyroidism: A Single-Center Experience"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7270-7211","authenticated-orcid":true,"given":"Claudio","family":"Casella","sequence":"first","affiliation":[{"name":"Department of Molecular and Translational Medicine, Surgical Clinic, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5683-6841","authenticated-orcid":true,"given":"Alessandro","family":"Galani","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Totaro","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Ministrini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7199-2954","authenticated-orcid":true,"given":"Silvia","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Dimko","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, ASST Carlo Poma, Mantova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazario","family":"Portolani","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl692"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.169"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2008.00627.x"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1159\/000046084"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-016-1447-7"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1833-2"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.188"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2010.02.340"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.5152\/balkanmedj.2014.9544"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-015-1344-5"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-9943-3"},{"key":"12","first-page":"549","volume":"101","year":"1987","journal-title":"Surgery"},{"key":"13","first-page":"34","volume":"78","year":"1975","journal-title":"Surgery"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(98)70067-4"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2099.101427"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-015-0098-x"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9092-5"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-005-3150-0"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1554689"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12310"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0379-0"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-200112000-00002"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197607082950201"},{"issue":"1","key":"24","first-page":"49","volume":"75","year":"1974","journal-title":"Surgery"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.09.029"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-2941-6"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.10.010"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-012-1025-6"},{"issue":"6","key":"29","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s00268-004-7321-8","volume":"28","year":"2004","journal-title":"World Journal of Surgery"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5450-6"},{"key":"31","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1671-4"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13029"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2017.05.008"},{"key":"34","volume":"4","year":"2018","journal-title":"Up To dateJan"},{"key":"35","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1996.483"},{"key":"36","doi-asserted-by":"publisher","DOI":"10.4183\/aeb.2013.385"},{"key":"37","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.04.027"},{"key":"38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.05.019"},{"key":"39","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-6-41"},{"key":"40","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1776-7"},{"key":"41","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0441"}],"container-title":["International Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/ije\/2018\/6065720.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ije\/2018\/6065720.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ije\/2018\/6065720.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T17:34:19Z","timestamp":1751736859000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/ije\/2018\/6065720\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,9]]},"references-count":41,"alternative-id":["6065720","6065720"],"URL":"https:\/\/doi.org\/10.1155\/2018\/6065720","relation":{},"ISSN":["1687-8337","1687-8345"],"issn-type":[{"value":"1687-8337","type":"print"},{"value":"1687-8345","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,9]]}}}