Reply to High calcium levels and supplementation

Forum Index » Health and Medicine

Reply to "High calcium levels and supplementation"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous]^^. Having said this I don't think they operate on the elderly as it is too high risk an operation.[/quote]

Your statement is wrong.  Parathyroidectomy is absolutely done in the elderly, but, as with any parathyroidectomy, safety and efficacy depend on having the surgery done by a high volume surgeon who does minimally invasive surgery.  Just before I had mine, my surgeon told me she operated on a 90 year old.

Of course, any surgery decision depends on individual patient factors, but there is no general prohibition on parathyroidectomy for the elderly, and when done by a high volume surgeon with minimal invasive procedures, it is not a "high risk" operation.  And, surgery is the only cure for hyperparathyroidism, which can cause kidney stones and osteoporosis and has many other symptoms, so just going untreated is not always an option.

Here are some papers:

1) 
Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT)
by Michael J Stechman  1 , Mary Weisters, Fergus V Gleeson, Gregory P Sadler, Radu Mihai
 Endocrinol (Oxf)
. 2009 Dec;71(6):787-91.  doi: 10.1111/j.1365-2265.2009.03540.x. Epub 2009 Feb 16.
[url]https://pubmed.ncbi.nlm.nih.gov/19222492/[/url]

"Parathyroidectomy is safe in the elderly and is associated with a significant improvement in symptoms. As survival after operation is similar to younger patients, surgery should be considered in all elderly patients with PHPT."

2) Parathyroidectomy for primary hyperparathyroidism in the elderly: experience of a single endocrine surgery center
ng Clin Exp Res
. 2017 Feb;29(Suppl 1):15-21.  doi: 10.1007/s40520-016-0666-7. Epub 2016 Nov 11.
[url]https://pubmed.ncbi.nlm.nih.gov/27837463/[/url] 
This study compared outcomes in three groups - under 65, 65-74, and 75+ years old.  There were no significant differences in outcomes (length of stay similar, no major complications in any group and no cases of mortality). The study concluded, "Parathyroidectomy is a safe and effective procedure to perform in elderly patients. Multiglandular disease was found to be more prevalent in older patients, but minimally invasive parathyroidectomy can be performed safely. Surgeons should consider parathyroidectomy in patients with primary hyperparathyroidism regardless of age."

3) Asian J Surg 2021 Jan;44(1):321-328.  doi: 10.1016/j.asjsur.2020.07.022.  Epub 2020 Sep 3.
Being elderly is not a contraindication of parathyroidectomy for renal hyperparathyroidism and chronic kidney disease-mineral and bone disorder
https://pubmed.ncbi.nlm.nih.gov/32891512/
Both groups exhibited significant postoperative improvement on the BMD results. The recovery potential of the elderly was not lower than the younger group. High success rate and none of persistent vocal palsy, hypocalcemia or any sequela were also observed in the elderly. Conclusions: Parathyroidectomy is an effective and safe intervention for the CKD-MBD in the elderly.

There are many other studies like this.[/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics