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Journals / Medical Network Klinik Bilimler ve Doktor / 2002 / Cilt: 8 - Sayı: 4

Surgical treatment in primary hyperparathyroidism

Primer hiperparatiroidizmde cerrahi tedavi

Savaş KOÇAK
Semih AYDINTUĞ
Semih BASKAN
Pages
461–465
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Minimal invasive techniques are not appropriate in our patient group because of the high ratio of accompanying thyroid pathologies.

📌 3 Key Takeaways

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Objective & Hypothesis:OBJECTIVE: Recent advances have allowed minimally invasive parathyroidectomy techniques in surgical treatment of primary hyperparathyroidism and bilateral servical exploration of the neck is questioned.
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Key Findings & Data:MATERIAL AND METHODS: Between 1993 and 2001, 120 patients with primary hyperparathyroidism were surgically treated and followed-up at least for 6 months by the authors.
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Conclusion & Impact:Minimal invasive techniques are not appropriate in our patient group because of the high ratio of accompanying thyroid pathologies.
🔬Design:Research Article
📍Scope:2001 Verileri
⚙️Variables:Paratiroid hormonu · Cerrahi işlemler · minimal invaziv

Abstract

OBJECTIVE: Recent advances have allowed minimally invasive parathyroidectomy techniques in surgical treatment of primary hyperparathyroidism and bilateral servical exploration of the neck is questioned. We aimed to discuss our success in parathyroid surgery. MATERIAL AND METHODS: Between 1993 and 2001, 120 patients with primary hyperparathyroidism were surgically treated and followed-up at least for 6 months by the authors. Bilateral neck exploration was performed in 112 (93.3 %), and unilateral exploration in 8 (6.7 %) cases. Nodular goiter accompanied pHPT in 76 (63.3 %) patients. RESULTS: Histopathological examination of the parathyroid glands revealed 6 (5 %) cancers, 103 (85.8 %) single adenomas, and 11 (9.2 %) multiglandular (adenoma/hyperplasia) disease. There were 4 thyroid carcinomas. Serum calcium levels decreased to normal or below-normal levels postoperatively in 118 patients. Thirty-five patients (29.4%) had elevated parathormone levels (PTH) in the first month. All of these 35 patients with postoperative normocalcemic hyperparathyroidism were re-evaluated 6 months later, and their PTH levels were found to be normal.Recurrent pHPT occurred in 1 patient, and she underwent a second exploration 3 years later. CONCLUSION: Our results reveal that we are successful in the surgical treatment of primary hyperparathyroidism . Minimal invasive techniques are not appropriate in our patient group because of the high ratio of accompanying thyroid pathologies.

Özet

AMAÇ: Son yıllarda minimal invazif paratiroidektomi teknikleri giderek yaygınlaşmış, ve primer hiperparatiroidizmin cerrahi tedavisinde rutin bilateral servikal eksplorasyonun gerekliliği tartışılır hale gelmiştir. Bu çalışmada amacımız bizim paratiroid cerrahisindeki deneyim ve başarımızı tartışmaktır. GEREÇ VE YÖNTEM: Birimimizde 1993 - 2001 yıllarında cerrahi tedavi uygulanan ve en az 6 aylık ameliyat sonrası izlem süresi olan 120 primer hiperparatiroidizm (pHPT) hastası geriye dönük olarak değerlendirilmiştir. Yüzoniki hastaya bilateral, 8 hastaya ise tek taraflı servikal eksplorasyon yapılmıştır. Bilateral girişim yapılanlardan üçü daha önce başka merkezlerde negatif eksplorasyonlar yapılmış hastalardır. Yetmişaltı hastada (% 63.3) nodüler guatr saptanmıştır. Altmışüç hastaya (% 52.5) aynı girişimde tiroidektomi de yapılmıştır. BULGULAR: Histopatolojik incelemede 6 paratiroid kanseri, 103 tek adenom, ve 11 multiglandüler (adenom/hiperplazi) saptanmıştır. Dört hastada tiroid dokusunda kanser bulunmuştur. Ameliyat sonrasında 118 hastada normokalsemi veya hipokalsemi saptanmıştır. Bir ay sonra 35 hastada (% 29.4), kalsiyum düzeyi normalken, parathormon (PTH) yüksek bulunmuştur. Bu olguların tümünde 6 - 12 ay sonra PTH düzeyleri normale dönmüştür. Bir hastada 3 yıl sonra nüks pHPT gelişmiş ikinci bir girişim uygulanmıştır. SONUÇ: pHPT cerrahi tedavisinde başarı oranımız yüksektir. Serimizde tek adenom oranı oldukça yüksek bulunmuştur, ancak eşlik eden tiroid patolojilerinin sıklığı, minimal invazif girişimleri olanaksız hale getirmektedir. Başarılı pHPT cerrahisi sonrasında PTH düzeyleri geçici olarak normalin üzerinde kalabilmektedir. Hiperkalseminin düzelmesi tedavinin başarılı olduğunu göstermek için yeterlidir.

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Cite This Article

KOÇAK, S., AYDINTUĞ, S., BASKAN, S. (2002). Surgical treatment in primary hyperparathyroidism. Medical Network Klinik Bilimler ve Doktor, Cilt: 8 - Sayı: 4, 461–465. https://ajindex.com/articles/278561

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