Goldstein R E, Martin W H, Richards K
Kenneth vonRoenn MD Family Chair in Surgical, Endocrinology and Professor of Surgery, University of Louisville, KY 40202, USA.
Minerva Chir. 2003 Jun;58(3):269-79.
The technique of parathyroidectomy has traditionally involved a bilateral exploration of the neck with the intent of visualizing 4 parathyroid glands and resecting pathologically enlarged glands. Parathyroid scanning using technetium-99m sestamibi has evolved and can now localize 80% to 90% of parathyroid adenomas. The technique of minimally invasive radioguided parathyroidectomy (MIRP) is a surgical option for most patients with primary hyperparathyroidism and a positive preoperative parathyroid scan. The technique makes use of a hand-held gamma probe that is used intraoperatively to guide the dissection in a highly directed manner with the procedure often performed under local anesthesia. The technique results in excellent cure rates while allowing most patients to leave the hospital within a few hours after the completion of the procedure. Current data also suggest the procedure can decrease hospital charges by approximately 50%. This technique may significantly change the management of primary hyperparathyroidism.
传统上，甲状旁腺切除术的技术包括对颈部进行双侧探查，目的是可视化4个甲状旁腺并切除病理上增大的腺体。使用锝-99m甲氧基异丁基异腈的甲状旁腺扫描技术已经发展，现在可以定位80%至90%的甲状旁腺腺瘤。微创放射性引导甲状旁腺切除术（MIRP）技术是大多数原发性甲状旁腺功能亢进且术前甲状旁腺扫描呈阳性患者的一种手术选择。该技术使用手持式γ探测器，术中用于以高度定向的方式指导解剖，该手术通常在局部麻醉下进行。该技术治愈率极高，同时大多数患者在手术完成后几小时内即可出院。目前的数据还表明，该手术可使住院费用降低约50%。这项技术可能会显著改变原发性甲状旁腺功能亢进的治疗方式。
