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Perioperative characteristics and short-term morbidity after surgery for renal hyperparathyroidism : Multicentre EUROCRINE® registry study

Van Den Heede, Klaas ; Brusselaers, Nele ; Almquist, Martin LU ; Riss, Philipp ; Raffaelli, Marco and Van Slycke, Sam (2025) In BJS Open 9(3).
Abstract

Background Parathyroid surgery is an appropriate alternative for renal hyperparathyroidism (rHPT) in patients in whom medical therapy fails. European morbidity and outcome data for clearly defined cohorts, potentially reflecting contemporary clinical practice, remain scarce. Method Data were extracted from the EUROCRINE® database on all operations for secondary rHPT between 1 January 2015 and 31 December 2021. Multivariable logistic regression analysis was used to identify risk factors for complications. Subgroup analyses were conducted for the two major surgical approaches (subtotal parathyroidectomy or total thyroidectomy with parathyroid transplantation), as well as for redo and concomitant thyroid surgery. The primary outcome was... (More)

Background Parathyroid surgery is an appropriate alternative for renal hyperparathyroidism (rHPT) in patients in whom medical therapy fails. European morbidity and outcome data for clearly defined cohorts, potentially reflecting contemporary clinical practice, remain scarce. Method Data were extracted from the EUROCRINE® database on all operations for secondary rHPT between 1 January 2015 and 31 December 2021. Multivariable logistic regression analysis was used to identify risk factors for complications. Subgroup analyses were conducted for the two major surgical approaches (subtotal parathyroidectomy or total thyroidectomy with parathyroid transplantation), as well as for redo and concomitant thyroid surgery. The primary outcome was 30-day morbidity. Results After excluding 324 patients, data were analysed for 1165 patients, who underwent primary surgery (859), redo surgery (135), or parathyroid surgery with concomitant (planned or unplanned) thyroid surgery (171). The postoperative complication rate was 13.8% (161 patients). Reintervention for bleeding was necessary in 22 patients (1.9%). The length of hospital stay was >1 week in 108 patients (9.8%), and was shorter in the redo parathyroidectomy than first-time parathyroidectomy group (52.0% (66) versus 36.6% (299) discharged within 2 days, respectively). No risk factors for complications could be identified in either the overall or subgroup analyses. In the case of redo surgery or primary surgery with concomitant thyroid surgery, recurrent laryngeal nerve palsy (6.7 versus 3.5%, respectively), revision surgery for bleeding (2.2 versus 1.2%, respectively), and wound infection rates (0.7 versus 0.0%, respectively) remained low. Conclusion This large European multicentre cohort study demonstrates the safety and low morbidity of parathyroid surgery for rHPT.

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type
Contribution to journal
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published
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BJS Open
volume
9
issue
3
article number
zraf048
publisher
Wiley
external identifiers
  • scopus:105008576193
  • pmid:40503605
ISSN
2474-9842
DOI
10.1093/bjsopen/zraf048
language
English
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yes
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Publisher Copyright: © 2025 The Author(s).
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8a85b983-f3f4-4648-bf97-14f5d45b717b
date added to LUP
2025-12-17 14:46:58
date last changed
2025-12-18 03:00:10
@article{8a85b983-f3f4-4648-bf97-14f5d45b717b,
  abstract     = {{<p>Background Parathyroid surgery is an appropriate alternative for renal hyperparathyroidism (rHPT) in patients in whom medical therapy fails. European morbidity and outcome data for clearly defined cohorts, potentially reflecting contemporary clinical practice, remain scarce. Method Data were extracted from the EUROCRINE® database on all operations for secondary rHPT between 1 January 2015 and 31 December 2021. Multivariable logistic regression analysis was used to identify risk factors for complications. Subgroup analyses were conducted for the two major surgical approaches (subtotal parathyroidectomy or total thyroidectomy with parathyroid transplantation), as well as for redo and concomitant thyroid surgery. The primary outcome was 30-day morbidity. Results After excluding 324 patients, data were analysed for 1165 patients, who underwent primary surgery (859), redo surgery (135), or parathyroid surgery with concomitant (planned or unplanned) thyroid surgery (171). The postoperative complication rate was 13.8% (161 patients). Reintervention for bleeding was necessary in 22 patients (1.9%). The length of hospital stay was &gt;1 week in 108 patients (9.8%), and was shorter in the redo parathyroidectomy than first-time parathyroidectomy group (52.0% (66) versus 36.6% (299) discharged within 2 days, respectively). No risk factors for complications could be identified in either the overall or subgroup analyses. In the case of redo surgery or primary surgery with concomitant thyroid surgery, recurrent laryngeal nerve palsy (6.7 versus 3.5%, respectively), revision surgery for bleeding (2.2 versus 1.2%, respectively), and wound infection rates (0.7 versus 0.0%, respectively) remained low. Conclusion This large European multicentre cohort study demonstrates the safety and low morbidity of parathyroid surgery for rHPT.</p>}},
  author       = {{Van Den Heede, Klaas and Brusselaers, Nele and Almquist, Martin and Riss, Philipp and Raffaelli, Marco and Van Slycke, Sam}},
  issn         = {{2474-9842}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{3}},
  publisher    = {{Wiley}},
  series       = {{BJS Open}},
  title        = {{Perioperative characteristics and short-term morbidity after surgery for renal hyperparathyroidism : Multicentre EUROCRINE® registry study}},
  url          = {{http://dx.doi.org/10.1093/bjsopen/zraf048}},
  doi          = {{10.1093/bjsopen/zraf048}},
  volume       = {{9}},
  year         = {{2025}},
}