Lindekleiv Haakon, Due Jan, Thuy Lu, Hansen Tor Arne, Nilsen Paul Age
Avdeling for urologi og endokrin kirurgi, Nukleaermedisinsk seksjon, Universitetssykehuset Nord-Norge, Postboks 100, 9038 Tromsø.
Tidsskr Nor Laegeforen. 2007 May 3;127(9):1204-6.
Parathyroid glands have traditionally been identified by bilateral neck exploration under general anaesthesia in connection with surgical removal of enlarged glands in primary hyperparathyroidism. Unilateral neck exploration can now be done under local anaesthesia without dissecting all glands, due to improved preoperative scintigraphy and measurement of parathyroid hormone (PTH) intra-operatively. This minimally invasive technique was introduced at the University Hospital of Northern Norway in 2004.
Data on patients who had undergone minimally invasive surgery were collected from patient files from 1 January 2004 to 31 December 2006. 41 patients were included in the study.
PTH had normalized for 97% of the patients post-operatively. 7% of the patients had transient hypocalcaemia at discharge. One patient suffered from paralysis of the recurrent laryngeal nerve after surgery. Local anaesthesia had to be converted to general anaesthesia for seven operations (17%).
Preoperative scintigraphy and intra-operative measurements of PTH have made minimally invasive surgery possible. It is currently our preferred treatment in case of unilateral pathology in the parathyroid glands.
传统上，甲状旁腺是在全身麻醉下通过双侧颈部探查来识别的，这与原发性甲状旁腺功能亢进症中肿大腺体的手术切除有关。由于术前闪烁扫描和术中甲状旁腺激素（PTH）测量的改进，现在可以在局部麻醉下进行单侧颈部探查，而无需解剖所有腺体。这种微创技术于2004年在挪威北部大学医院引入。
从2004年1月1日至2006年12月31日的患者病历中收集接受微创手术患者的数据。41名患者纳入研究。
97%的患者术后PTH恢复正常。7%的患者出院时出现短暂性低钙血症。一名患者术后出现喉返神经麻痹。七例手术（17%）不得不将局部麻醉改为全身麻醉。
术前闪烁扫描和术中PTH测量使微创手术成为可能。目前，对于甲状旁腺单侧病变，这是我们首选的治疗方法。
