Spelsberg F, Peller-Sautter R H
Abteilung für Allgemein- und Endokrine Chirurgie, Krankenhaus Martha-Maria, München.
Chirurg. 1999 Oct;70(10):1102-12. doi: 10.1007/s001040050871.
The aim of surgical intervention in the treatment of primary hyperparathyroidism (pHPT) is the achievement of normocalcemia and euparathyreosis. Despite improved diagnostic procedures containing comparatively modified pre- and intraoperative methods to determine the position of the parathyroid glands and the most efficient operative technique including minimal-invasive surgery thereof, success cannot be guaranteed. Therefore, we should strive to avoid reintervention by ensuring a hemorrhage-free, atraumatic, anatomical-orientated operation and providing positive preconditions for reoperation. Success is based on the four pillars of the HPT surgery: history, embryology with anatomy, neck surgery and experience. By means of this principle and the results of surgical treatment in 1634 patients with pHPT from 1982 until 1998, we demonstrate a standardized operative technique of pHPT.
手术干预治疗原发性甲状旁腺功能亢进症（pHPT）的目的是实现血钙正常和甲状旁腺功能正常。尽管诊断程序有所改进，包括相对改良的术前和术中确定甲状旁腺位置的方法以及最有效的手术技术，包括其微创手术，但仍无法保证成功。因此，我们应努力通过确保无出血、无创伤、以解剖为导向的手术并为再次手术提供积极的前提条件来避免再次干预。成功基于HPT手术的四大支柱：病史、胚胎学与解剖学、颈部手术和经验。借助这一原则以及1982年至1998年期间对1634例pHPT患者的手术治疗结果，我们展示了pHPT的标准化手术技术。
