ABSTRACT
Objective:To evaluate the feasibility and effectiveness of parathyroid autotransplantation in subcutaneous tissue of upper abdomen after total parathyroidectomy in patients with severe secondary hyperparathyroidism (SHPT).Methods:From January 2018 to January 2020, retrospective reviews were conducted for clinical data of 29 patients with secondary hyperparathyroidism undergoing epigastric parathyroid autotransplantation after total parathyroidectomy.Clinical and biochemical characteristics were recorded.Serum levels of calcium, phosphorus, parathyroid hormone and alkaline phosphatase before and after operation were analyzed by paired sample t-test and the difference was statistically significant ( P<0.01). The follow-up period was 1, 3, 6 and 12 months post-operation and yearly after 12 months. Results:All operations were successful.The postoperative levels of calcium[(2.25±0.32) vs.(2.49±0.24) mmol/L], phosphorus[(1.72±0.65) vs. (2.09±0.75) mmol/L], alkaline phosphatase[(199.02±77.68) vs.(384.21±154.5) U/L]and parathyroid hormone (PTH)[(8.01±7.00) vs.(1 930.64±620.51) pg/ml]were significantly lower than the preoperative levels ( P<0.01). And the differences were statistically significant.And 17/18 hypertensive patients improved post-operation; postoperative improvement was not obvious for 21 anemic patients, 17 patients improved within 1 year.Among 26 cases with bone pain, 16 cases disappeared immediately postoperatively, 5 disappeared within 1 month and 5 within 3 months.Among 13 cases with skin itch, 10 cases disappeared immediately and 3 cases at 1 month post-operation.The level of PTH recovered at different follow-up timepoints with an average recovery time of (4.45±2.31) months. Conclusions:Autologous transplantation of parathyroid gland in epigastric subcutaneous tissue after parathyroidectomy is both safe and effective for secondary hyperparathyroidism.
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Objective To study the effect of endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs.Methods Clinical data of 112 patients undergoing endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs from Oct 2011 to Feb 2016 was retrospectively evaluated.Results Patients had average 2-6 perforating veins in their affected lower limbs.Procedures were successful in all the patients,all the superficial varicose veins disappeared after 1 month and 1 year of ultrasound follow-up,perforating veins closed,ulcer healed,and chromatosis alleviated.Conclusion Endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs is effective,safe and quick recovery.
ABSTRACT
Objective To evaluate selective retention of the great saphenous vein (GSV) belowknee in the prevention of saphenous nerve injury during varicose veins surgery.Methods From January 2009 to January 2012,280 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups.Patients in the experimental group underwent stripping restricted to the below knee level,patients in control group underwent GSV stripping to the ankle level Patients in the two groups were treated with transilluminated powered phlebectomy,and foam sclerotherapy.Primary end points were postoperative pain,saphenous nerve injury,quality of life and recurrence rate.Results After one month follow-up:5.71％ patients had symptoms of nervous system in the observation group,14.29％ patients had symptoms of nervous system in the control group (P =0.02).After 1 year follow-up,1.47％ patients had symptoms of nervous system in the observation group,7.14％ patients had symptoms of nervous system in the control group (P =0.02).Conclusions Selective retention of great saphenous vein below-knee decreases saphenous nerve injury.