| 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novel techniques have outdated the conventional surgical procedure is questionable.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. |
