Sayad H, Jai S Rifki, Ahazzam J, Lakhloufi A, Chihab F, Bouzidi A, Aghai R, Tarass F, Ramdani B, Hachim K, Benghanem N G, Zaid D
Service de Chirurgie Générale (Aile III), CHU Ibn Rochd, Casablanca, Maroc.
Tunis Med. 2008 Feb;86(2):140-3.
The aim of this study was to report the experience of the department of general surgery (Aile III) Ibn Rochd Hospital in surgical management of hyperparathyroidism in patients with end-stage renal disease (ESRD).
Fifty seven patients (24 M, 33F) with hyperparathyroidism underwent surgical parathyroidectomy from 1998 to 2004. Surgical indication was established according to clinical or biological assessment. Fifty nine operations were performed (57 first-hand cervicotomies and resumptions in too cases).
Histological examination of parathyroid gland specimens disclosed adenoma in 33 patients and hyperplasia in 14 patients. The follow-up was normal in 52 patients, marqued by cervical hematoma in 2 cases and death was deplored in 4 patients. The post-operative calcium level was in the normal range in 43 cases, low comparatively to the baseline in 12 cases and high in 2 cases. The PTH levelwas normal in 55 patients and high in two patients. Long-term outcome was evaluated in 36 patients mean follow-up (18 months). A good evolution was noted in all patient referring to clinical, biological and radiological investigations.
That, in our context, surgical parathyroidectomy still an appropriate approach for the treatment of hyperparathyroidism in patients with end-stage renal disease.
本研究旨在报告伊本·鲁世德医院普通外科（第三科室）在终末期肾病（ESRD）患者甲状旁腺功能亢进症外科治疗方面的经验。
1998年至2004年，57例甲状旁腺功能亢进症患者（24例男性，33例女性）接受了甲状旁腺切除术。根据临床或生物学评估确定手术指征。共进行了59次手术（57例初次颈部切开术，2例再次手术）。
甲状旁腺标本的组织学检查显示，33例患者为腺瘤，14例患者为增生。52例患者随访正常，2例出现颈部血肿，4例患者死亡。43例患者术后血钙水平在正常范围内，12例相对基线水平较低，2例较高。55例患者的甲状旁腺激素（PTH）水平正常，2例患者较高。对36例患者进行了平均18个月的长期随访。根据临床、生物学和放射学检查，所有患者病情均有良好进展。
在我们的研究背景下，外科甲状旁腺切除术仍是终末期肾病患者甲状旁腺功能亢进症的一种合适治疗方法。
