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Protocol driven outcomes in renal parathyroid surgery
Author(s) -
Walsh Nathaniel J.,
Caten Alexander J.,
White John J.,
Terris David J.
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25413
Subject(s) - medicine , parathyroidectomy , perioperative , cohort , surgery , population , primary hyperparathyroidism , hyperparathyroidism , parathyroid hormone , urology , calcium , environmental health
Background Patients who require surgery for renal hyperparathyroidism represent a special population that is at high risk for postoperative complications. To optimize their treatment, we developed a multidisciplinary approach to the perioperative management of these patients undergoing parathyroidectomy. Methods The Augusta University endocrine surgery parathyroid database was interrogated to identify dialysis‐dependent patients undergoing parathyroidectomy from 2005 to 2015. Numerous clinical parameters were quantified. Patients were stratified into protocol patients and nonprotocol patients. Results A total of 42 patients undergoing renal parathyroidectomy who met the inclusion criteria were identified. Serious adverse events were nearly twice as common in the patients not treated on protocol. The length of stay was nearly 2 days shorter in the protocol group. Lowest calcium level and ionized calcium was higher in the protocol cohort despite a lower postoperative parathyroid hormone. The protocol group had fewer laboratory draws. Conclusion Implementation of a multidisciplinary renal hyperparathyroidism protocol has resulted in improved perioperative outcomes.