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篇名 Is Conventional Parathyroidectomy Obsolete in the Surgical Strategy for Parathyroid Adenoma?
作者 Ting-Min Hsieh, Cheuk-Kwan Sun, Fong-Fu Chou
卷期/出版年月 42卷1期 (2009/2)
頁次 20-30
摘要 Background: Parathyroidectomy has been the mainstay in the treatment of primary hyperparathyroidism (PHPT). Recently, several surgical strategies emphasizing minimal invasiveness of the procedure have been proposed, which, undeniably, are still being developed in a favorable direction. However, whether the novel techniques have outdated the conventional surgical procedure is questionable. This study is aimed to investigate the validity of conventional strategy for parathyroidectomy in a medical center with experienced surgeons. Methods: Of all the 111 patients operated on for primary hyperparathyroidism, 104 cases with pathologically proven parathyroid adenoma at a single medical center during the last 10 years were retrospectively reviewed. Results: All the 104 patients with parathyroid adenoma were successfully treated with unilateral parathyroidectomy and routine biopsy of an ipsilateral normalappearing gland, followed by bilateral exploration, if indicated. The overall sensitivity of preoperative localization was 67% for ultrasonography and 86% for the sestamibi scan. Conclusions: In treating parathyroid adenoma, unilateral exploration with removal of an abnormal gland and identification of an ipsilateral normal gland is considered effective in ruling out occult multiple gland disease. Our results showed that the conventional procedure could continue to achieve an excellent cure rate despite the claim of favorable results in the recent articles advocating “novel” techniques.
關鍵詞 hyperparathyroidism, neck exploration, sestamibi scan, ultrasonography
分類 Original Article

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