{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:41:22Z","timestamp":1792424482280,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":90,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Comparative studies of total parathyroidectomy (TPTX) and total parathyroidectomy with autotransplantation (TPTX\u2009+\u2009AT) 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed a nonrandomized cohort of 80 patients with refractory SHPT who underwent parathyroidectomy between January and December 2021 (TPTX,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940; TPTX\u2009+\u2009AT,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940). 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups achieved satisfactory short-term biochemical control without major perioperative complications. Operative time was longer in the TPTX\u2009+\u2009AT group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). Compared with the TPTX\u2009+\u2009AT 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TPTX and TPTX\u2009+\u2009AT yielded satisfactory short-term biochemical outcomes. TPTX\u2009+\u2009AT 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12902-026-02430-8","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:05:23Z","timestamp":1784624723000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Total parathyroidectomy versus total parathyroidectomy with autotransplantation for refractory secondary hyperparathyroidism: short-term biochemical outcomes and postoperative calcium supplementation burden"],"prefix":"10.1186","volume":"26","author":[{"given":"Horng-Shiuan","family":"See","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kian-Hwee","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tien","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3059-0724","authenticated-orcid":false,"given":"Chieh-Wen","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"issue":"1","key":"2430_CR1","first-page":"1","volume":"7","author":"M Ketteler","year":"2017","unstructured":"Ketteler M, Block GA, Evenepoel P, Fukagawa M, Herzog CA, McCann L, et al. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2017;7(1):1\u201359.","journal-title":"Kidney Int Suppl"},{"issue":"8","key":"2430_CR2","doi-asserted-by":"publisher","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","volume":"15","author":"GA Block","year":"2004","unstructured":"Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208\u201318.","journal-title":"J Am Soc Nephrol"},{"issue":"6","key":"2430_CR3","doi-asserted-by":"publisher","first-page":"1948","DOI":"10.1093\/ndt\/gfq219","volume":"26","author":"J Floege","year":"2011","unstructured":"Floege J, Kim J, Ireland E, Chazot C, Drueke T, de Vos J, et al. Serum iPTH, calcium and phosphate, and the risk of mortality in a European haemodialysis population. Nephrol Dial Transpl. 2011;26(6):1948\u201355.","journal-title":"Nephrol Dial Transpl"},{"issue":"26","key":"2430_CR4","doi-asserted-by":"publisher","first-page":"2482","DOI":"10.1056\/NEJMoa1205624","volume":"367","author":"GM Chertow","year":"2012","unstructured":"Chertow GM, Block GA, Correa-Rotter R, Drueke TB, Floege J, Goodman WG, et al. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med. 2012;367(26):2482\u201394.","journal-title":"N Engl J Med"},{"issue":"2","key":"2430_CR5","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1038\/ki.2015.72","volume":"88","author":"H Komaba","year":"2015","unstructured":"Komaba H, Taniguchi M, Wada A, Iseki K, Tsubakihara Y, Fukagawa M. Parathyroidectomy and survival among Japanese hemodialysis patients with secondary hyperparathyroidism. Kidney Int. 2015;88(2):350\u20139.","journal-title":"Kidney Int"},{"key":"2430_CR6","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1007\/s00423-025-03744-2","volume":"410","author":"WP Duggan","year":"2025","unstructured":"Duggan WP, Patterson R, Smyth NM, Kyne N, Synnott D, McHugh N, et al. A retrospective analysis of the management of renal hyperparathyroidism: evaluating changes in practice and outcome in an era of calcimimetics. Langenbecks Arch Surg. 2025;410:172.","journal-title":"Langenbecks Arch Surg"},{"key":"2430_CR7","doi-asserted-by":"publisher","first-page":"1059828","DOI":"10.3389\/fendo.2022.1059828","volume":"13","author":"LX Zhang","year":"2022","unstructured":"Zhang LX, Zhang B, Liu XY, Wang ZM, Qi P, Zhang TY, Zhang Q. Advances in the treatment of secondary and tertiary hyperparathyroidism. Front Endocrinol. 2022;13:1059828.","journal-title":"Front Endocrinol"},{"issue":"6","key":"2430_CR8","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1007\/BF01665309","volume":"15","author":"M Rothmund","year":"1991","unstructured":"Rothmund M, Wagner PK, Schark C. Subtotal parathyroidectomy versus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial. World J Surg. 1991;15(6):745\u201350.","journal-title":"World J Surg"},{"issue":"9","key":"2430_CR9","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1055\/s-0035-1554689","volume":"47","author":"J Chen","year":"2015","unstructured":"Chen J, Zhou QY, Wang JD. Comparison between subtotal parathyroidectomy and total parathyroidectomy with autotransplantation for secondary hyperparathyroidism in patients with chronic renal failure: a meta-analysis. Horm Metab Res. 2015;47(9):643\u201351. https:\/\/doi.org\/10.1055\/s-0035-1554689.","journal-title":"Horm Metab Res"},{"issue":"3","key":"2430_CR10","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1016\/j.surg.2023.09.016","volume":"175","author":"KA Baugh","year":"2024","unstructured":"Baugh KA, Yip L, Ramonell KM, Carty SE, McCoy KL. Outcomes of subtotal parathyroidectomy for renal hyperparathyroidism. Surgery. 2024;175(3):788\u201393. https:\/\/doi.org\/10.1016\/j.surg.2023.09.016.","journal-title":"Surgery"},{"issue":"3","key":"2430_CR11","doi-asserted-by":"publisher","first-page":"277","DOI":"10.3109\/2000-1967-047","volume":"111","author":"Y Tominaga","year":"2006","unstructured":"Tominaga Y. Surgical treatment of secondary hyperparathyroidism due to chronic kidney disease. Ups J Med Sci. 2006;111(3):277\u201392.","journal-title":"Ups J Med Sci"},{"issue":"10","key":"2430_CR12","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1007\/s00268-007-9187-z","volume":"31","author":"K Schlosser","year":"2007","unstructured":"Schlosser K, Endres N, Celik I, Fendrich V, Rothmund M, Fernandez ED. Surgical treatment of tertiary hyperparathyroidism: the choice of procedure matters! World J Surg. 2007;31(10):1947\u201353.","journal-title":"World J Surg"},{"issue":"2","key":"2430_CR13","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1007\/s00268-011-1392-0","volume":"36","author":"R Schneider","year":"2012","unstructured":"Schneider R, Slater EP, Karakas E, Bartsch DK, Schlosser K. Initial parathyroid surgery in 606 patients with renal hyperparathyroidism. World J Surg. 2012;36(2):318\u201326.","journal-title":"World J Surg"},{"key":"2430_CR14","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.ijsu.2017.06.029","volume":"44","author":"ME Liu","year":"2017","unstructured":"Liu ME, Qiu NC, Zha SL, Du ZP, Wang YF, Wang Q, et al. To assess the effects of parathyroidectomy (TPTX versus TPTX\u2009+\u2009AT) for secondary hyperparathyroidism in chronic renal failure: a systematic review and meta-analysis. Int J Surg. 2017;44:353\u201362.","journal-title":"Int J Surg"},{"issue":"6","key":"2430_CR15","doi-asserted-by":"publisher","first-page":"856","DOI":"10.3904\/kjim.2015.30.6.856","volume":"30","author":"BH Kang","year":"2015","unstructured":"Kang BH, Hwang SY, Kim JY, Hong YA, Jung MY, Lee EA, et al. Predicting postoperative total calcium requirements after parathyroidectomy in secondary hyperparathyroidism. Korean J Intern Med. 2015;30(6):856\u201364. https:\/\/doi.org\/10.3904\/kjim.2015.30.6.856.","journal-title":"Korean J Intern Med"},{"key":"2430_CR16","first-page":"1161","volume":"4","author":"L Lv","year":"2019","unstructured":"Lv L, Li S, Ye Y, Hu W, Liu X. Total parathyroidectomy alone or with autotransplantation for secondary hyperparathyroidism in end-stage renal disease patients: a systematic review and meta-analysis. J Urol Ren Dis. 2019;4:1161.","journal-title":"J Urol Ren Dis"},{"issue":"5","key":"2430_CR17","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1007\/s11255-022-03401-3","volume":"55","author":"X Gong","year":"2023","unstructured":"Gong X, Wang YA, Li C, Liao X, Li S, Yang L, et al. Effect of total parathyroidectomy in patients with secondary hyperparathyroidism: a retrospective study. Int Urol Nephrol. 2023;55(5):1239\u201345.","journal-title":"Int Urol Nephrol"},{"issue":"5","key":"2430_CR18","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1097\/00000658-198811000-00016","volume":"208","author":"H Takagi","year":"1988","unstructured":"Takagi H, Tominaga Y, Tanaka Y, Uchida K, Orihara A, Yamada N, et al. Total parathyroidectomy with forearm autograft for secondary hyperparathyroidism in chronic renal failure. Ann Surg. 1988;208(5):639\u201344. https:\/\/doi.org\/10.1097\/00000658-198811000-00016.","journal-title":"Ann Surg"},{"issue":"2","key":"2430_CR19","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1002\/(SICI)1098-2388(199703\/04)13:2<78::AID-SSU3>3.0.CO;2-Z","volume":"13","author":"Y Tominaga","year":"1997","unstructured":"Tominaga Y, Tanaka Y, Sato K, Nagasaka T, Takagi H. Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism. Semin Surg Oncol. 1997;13(2):78\u201386.","journal-title":"Semin Surg Oncol"},{"issue":"1","key":"2430_CR20","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1097\/00000658-200201000-00013","volume":"235","author":"FF Chou","year":"2002","unstructured":"Chou FF, Lee CH, Chen HY, Chen JB, Hsu KT, Sheen-Chen SM. Persistent and recurrent hyperparathyroidism after total parathyroidectomy with autotransplantation. Ann Surg. 2002;235(1):99\u2013104.","journal-title":"Ann Surg"},{"issue":"4","key":"2430_CR21","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1177\/1457496919866015","volume":"109","author":"WY van der Plas","year":"2020","unstructured":"van der Plas WY, Noltes ME, van Ginhoven TM, Kruijff S. Secondary and tertiary hyperparathyroidism: a narrative review. Scand J Surg. 2020;109(4):271\u20138. https:\/\/doi.org\/10.1177\/1457496919866015.","journal-title":"Scand J Surg"},{"issue":"5","key":"2430_CR22","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1097\/SLA.0000000000001875","volume":"264","author":"K Schlosser","year":"2016","unstructured":"Schlosser K, Bartsch DK, Diener MK, Seiler CM, Bruckner T, Nies C, et al. Total parathyroidectomy with routine thymectomy and autotransplantation versus total parathyroidectomy alone for secondary hyperparathyroidism: results of a nonconfirmatory multicenter prospective randomized controlled pilot trial. Ann Surg. 2016;264(5):745\u201353. https:\/\/doi.org\/10.1097\/SLA.0000000000001875.","journal-title":"Ann Surg"},{"issue":"1","key":"2430_CR23","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.surg.2018.04.076","volume":"165","author":"E Isaksson","year":"2019","unstructured":"Isaksson E, Ivarsson K, Akaberi S, Muth A, Prutz KG, Clyne N, Almquist M. Total versus subtotal parathyroidectomy for secondary hyperparathyroidism. Surgery. 2019;165(1):142\u201350. https:\/\/doi.org\/10.1016\/j.surg.2018.04.076.","journal-title":"Surgery"},{"issue":"1","key":"2430_CR24","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1097\/00000658-200101000-00011","volume":"233","author":"G Gasparri","year":"2001","unstructured":"Gasparri G, Camandona M, Abbona GC, Papotti M, Jeantet A, Radice E, Mullineris B. Secondary and tertiary hyperparathyroidism: causes of recurrent disease after 446 parathyroidectomies. Ann Surg. 2001;233(1):65\u20139.","journal-title":"Ann Surg"},{"issue":"2","key":"2430_CR25","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1007\/s00268-008-9765-8","volume":"33","author":"ML Shih","year":"2009","unstructured":"Shih ML, Duh QY, Hsieh CB, Lin SH, Wu HS, Chu PL, et al. Total parathyroidectomy without autotransplantation for secondary hyperparathyroidism. World J Surg. 2009;33(2):248\u201354. https:\/\/doi.org\/10.1007\/s00268-008-9765-8.","journal-title":"World J Surg"},{"issue":"6","key":"2430_CR26","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1007\/s00268-010-0412-9","volume":"34","author":"Y Tominaga","year":"2010","unstructured":"Tominaga Y, Matsuoka S, Uno N, Tsuzuki T, Hiramitsu T, Goto N, Nagasaka T, Watarai Y, Uchida K. Removal of autografted parathyroid tissue for recurrent renal hyperparathyroidism in hemodialysis patients. World J Surg. 2010;34(6):1312\u20137.","journal-title":"World J Surg"},{"issue":"1","key":"2430_CR27","doi-asserted-by":"publisher","first-page":"R21","DOI":"10.1530\/ERC-19-0284","volume":"27","author":"M Almquist","year":"2020","unstructured":"Almquist M, Isaksson E, Clyne N. The treatment of renal hyperparathyroidism. Endocr Relat Cancer. 2020;27(1):R21\u201334.","journal-title":"Endocr Relat Cancer"},{"issue":"8","key":"2430_CR28","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1093\/ckj\/sfac050","volume":"15","author":"G Cianciolo","year":"2022","unstructured":"Cianciolo G, Tondolo F, Barbuto S, Angelini A, Ferrara F, Iacovella F, et al. A roadmap to parathyroidectomy for kidney transplant candidates. Clin Kidney J. 2022;15(8):1459\u201374. https:\/\/doi.org\/10.1093\/ckj\/sfac050.","journal-title":"Clin Kidney J"},{"issue":"8","key":"2430_CR29","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.21037\/gs-23-54","volume":"12","author":"KA Black","year":"2023","unstructured":"Black KA, Galata G, Schulte KM, Hubbard JG. Comparing subtotal parathyroidectomy and total parathyroidectomy with autotransplantation in renal transplant recipients. Gland Surg. 2023;12(8):1060\u20136. https:\/\/doi.org\/10.21037\/gs-23-54.","journal-title":"Gland Surg"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-026-02430-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02430-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02430-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:03:18Z","timestamp":1792422198000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-026-02430-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2430"],"URL":"https:\/\/doi.org\/10.1186\/s12902-026-02430-8","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"assertion":[{"value":"21 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Institutional Review Board of Buddhist Tzu Chi General Hospital, Taipei branch (No. 14-IRB068) and was conducted in accordance with the Declaration of Helsinki. The requirement for informed consent was waived by the Institutional Review Board because of the retrospective nature of the study and the use of de-identified data.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"324"}}