Miyabe Rika
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
Surg Today. 2009;39(2):98-103. doi: 10.1007/s00595-008-3845-0. Epub 2009 Feb 7.
To evaluate the usefulness of three-dimensional (3D) ultrasonography (US) as a noninvasive preoperative localization procedure before performing minimally invasive focused parathyroidectomy in patients with primary hyperparathyroidism (pHPT).
Seventy-six patients with a solitary adenoma detected by US underwent minimally invasive focused parathyroidectomy. The value of 3D US was assessed by dividing patients into a 2D group and a 3D group. Age, the preoperative serum intact parathyroid hormone (PTH) level, operative time, length of skin incision, and weight of the resected specimen were compared between the groups, and multivariate analysis of the operative time was performed.
There were no significant differences between the 2D group and the 3D group in age, the preoperative intact PTH level, length of skin incision, or weight of the resected specimen, but the mean operative time was significantly longer in the 2D group (P < 0.01). Multivariate analysis revealed that 3D US and the weight of the resected specimen were correlated with the operative time (P < 0.05).
The coronal images obtained by 3D US assist in the precise localization of parathyroid masses in patients with pHPT undergoing minimally invasive focused parathyroidectomy for a solitary adenoma.
评估三维（3D）超声检查（US）作为原发性甲状旁腺功能亢进症（pHPT）患者进行微创聚焦甲状旁腺切除术之前的一种非侵入性术前定位方法的有效性。
76例经超声检查发现为单发腺瘤的患者接受了微创聚焦甲状旁腺切除术。通过将患者分为二维（2D）组和三维（3D）组来评估3D US的价值。比较两组患者的年龄、术前血清完整甲状旁腺激素（PTH）水平、手术时间、皮肤切口长度和切除标本重量，并对手术时间进行多因素分析。
2D组和3D组在年龄、术前完整PTH水平、皮肤切口长度或切除标本重量方面无显著差异，但2D组的平均手术时间明显更长（P < 0.01）。多因素分析显示，3D US和切除标本重量与手术时间相关（P < 0.05）。
3D US获得的冠状位图像有助于pHPT患者在因单发腺瘤接受微创聚焦甲状旁腺切除术时对甲状旁腺肿块进行精确定位。
