Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Endocr Pract. 2011 Mar-Apr;17 Suppl 1:83-9. doi: 10.4158/EP10377.RA.
To summarize the indications and techniques for parathyroid autotransplantation and to explore other aspects of the field that warrant further research and discussion.
Review of relevant literature with focus on parathyroid autotransplantation and cryopreservation.
Parathyroid autotransplantation is an important technique used by surgeons to circumvent postoperative hypoparathyroidism. Immediate autotransplantation is used intraoperatively, most commonly in the setting of total thyroidectomy or during total parathyroidectomy in a patient with parathyroid hyperplasia. Delayed autotransplantation with cryopreservation is typically used in patients with persistent or recurrent hyperparathyroidism who require repeated cervical exploration.
The success rate of autotransplantation in preventing postoperative hypoparathyroidism reported in the literature is highly variable and is dependent on timing, disease, and duration of tissue storage. Ultimately, surgical planning for patients with hyperparathyroidism involves finding a balance between decreasing a patient's symptoms, increasing the time of eucalcemia, and avoiding the complications of permanent hypoparathyroidism.
总结甲状旁腺自体移植的适应证和技术,并探讨该领域其他值得进一步研究和讨论的方面。
对甲状旁腺自体移植和冷冻保存的相关文献进行综述,重点关注这两个方面。
甲状旁腺自体移植是外科医生用来避免术后甲状旁腺功能减退的重要技术。即刻自体移植术在术中使用,最常用于全甲状腺切除术或甲状旁腺增生患者的全甲状旁腺切除术。延迟自体移植术联合冷冻保存术通常用于需要反复颈部探查的持续性或复发性甲状旁腺功能亢进患者。
文献报道的自体移植术预防术后甲状旁腺功能减退的成功率差异很大,取决于时机、疾病和组织储存时间。最终,甲状旁腺功能亢进患者的手术计划需要在减轻患者症状、延长血钙正常时间和避免永久性甲状旁腺功能减退症的并发症之间找到平衡。