经颈胸腺切除术治疗多发性内分泌腺瘤病1型相关甲状旁腺功能亢进的效用。
The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism.
作者信息
Powell Anathea C, Alexander H Richard, Pingpank James F, Steinberg Seth M, Skarulis Monica, Bartlett David L, Agarwal Sunita, Cochran Craig, Seidel Geoffrey, Fraker Douglas, Hughes Marybeth S, Jensen Robert T, Marx Stephen J, Libutti Steven K
机构信息
Tumor Angiogenesis Section, Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
出版信息
Surgery. 2008 Dec;144(6):878-83; discussion 883-4. doi: 10.1016/j.surg.2008.08.031.
Abstract
BACKGROUND
Operation for multiple endocrine neoplasia (MEN)1-related hyperparathyroidism (HPT) includes a neck exploration with resection of 3.5 or 4 parathyroid glands and transcervical thymectomy (TCT). We reviewed our experience with initial operation for primary HPT to determine the outcome and utility of routine TCT.
METHODS
All patients with MEN1 who underwent initial neck exploration from 1993 to 2007 under an institutional review board-approved protocol were reviewed.
RESULTS
We identified 66 patients with initial operation for HPT in MEN1. In 34 patients, 4 glands were found; in 32 patients, <4 glands were found. In 2 of the 34 (6%) and 17 of the 32 (53%), intrathymic parathyroid tissue was found on permanent pathology. No thymic carcinoid tissue was found in any specimen.
CONCLUSION
These data highlight the importance of performing TCT when <4 entopic parathyroid glands are found at first operation.
摘要
背景
多发性内分泌腺瘤病（MEN）1相关甲状旁腺功能亢进症（HPT）的手术包括颈部探查并切除3.5个或4个甲状旁腺以及经颈胸腺切除术（TCT）。我们回顾了我们对原发性HPT初次手术的经验，以确定常规TCT的结果和效用。
方法
回顾了1993年至2007年期间所有在机构审查委员会批准的方案下接受初次颈部探查的MEN1患者。
结果
我们确定了66例接受MEN1中HPT初次手术的患者。34例患者发现4个腺体；32例患者发现少于4个腺体。在34例中的2例（6%）和32例中的17例（53%）中，在永久病理学检查中发现了胸腺内甲状旁腺组织。任何标本中均未发现胸腺类癌组织。
结论
这些数据凸显了在初次手术时发现少于4个异位甲状旁腺腺体时进行TCT的重要性。
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