Bartsch G, Frick J, Baumgartner W
Urologe A. 1975 Jul;14(4):172-7.
By means of folow up of patients with operated primary hyperparathyreoidism (mainly renal manifestation) therefore neck exploration should be done on a broader scale and also the late results are reported. They indicate that a carefully considerated neck exploration is relatively free of risk. Of permanent postoperative complications in 83 operations made upon 76 patients only one case of a permanent unilateral paralysis of the recurrent laryngeal nerve was observed. The patients were subjectively free of symptoms; in the successfully operated patients stone recurrence or increase respectively growth of already existing urinary stones did not occur postoperatively. Those patients in whom repeatedly renal stones had been evident at the time of the operation, reported increased colics with partly spontaneous discharge of stones shortly after the operation; the i.v.p. controls showed no recurrent or additional formation of urinary stones in the patients, where we did successful neck exploration. The comparisons of the pre- and postoperative calcium levels indicate that the aim of the operation, normalisation of the calcium metabolism was obtained in almost all cases; only in 3 patients a hypercalcaemia remained. Mediastinotomy was performed only for two times. From these follow up we conclude that neck exploration carries a little risk compared to the high morbidity of primary hyperparathyreoidism (renal manifestation). Therefore neck exploration should be done on a broader scale and also in cases of diagnostic borderline values.
通过对接受原发性甲状旁腺功能亢进手术患者（主要为肾脏表现）的随访，因此颈部探查应更广泛地进行，并且报告了晚期结果。结果表明，经过仔细考虑的颈部探查相对风险较小。在对76例患者进行的83次手术中，术后永久性并发症仅观察到1例喉返神经永久性单侧麻痹。患者主观上无症状；在手术成功的患者中，术后未出现结石复发或已有肾结石增大或生长的情况。那些在手术时反复出现肾结石的患者，术后报告绞痛加剧，部分结石自行排出；静脉肾盂造影检查显示，在我们成功进行颈部探查的患者中，未出现结石复发或额外形成的情况。术前和术后钙水平的比较表明，手术目的即钙代谢正常化在几乎所有病例中均已实现；仅3例患者仍存在高钙血症。仅进行了两次纵隔切开术。从这些随访结果我们得出结论，与原发性甲状旁腺功能亢进（肾脏表现）的高发病率相比，颈部探查风险较小。因此，颈部探查应更广泛地进行，在诊断临界值的情况下也应进行。
