微创甲状旁腺切除术治疗原发性甲状旁腺功能亢进术中辅助治疗的结果分析。
Outcomes analysis of intraoperative adjuncts during minimally invasive parathyroidectomy for primary hyperparathyroidism.
机构信息
Department of Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
出版信息
Am J Surg. 2012 Feb;203(2):177-81. doi: 10.1016/j.amjsurg.2010.10.015. Epub 2011 Jul 14.
BACKGROUND
The aim of this study was to determine whether minimally invasive radioguided parathyroidectomy (MIRP) and intraoperative parathyroid hormone-guided parathyroidectomy (ioPTH) have equivalent intermediate-term outcomes in primary hyperparathyroidism (PHPT).
METHODS
A retrospective study of 244 patients who underwent parathyroidectomy for PHPT in a 25-month time period was conducted. Patients who either underwent MIRP- or ioPTH-guided parathyroidectomies were included. The primary outcome was persistent disease. Conversion to bilateral exploration, complications, and multigland disease (MGD) were secondary outcomes.
RESULTS
There was 1 MIRP patient and no ioPTH patients who had persistent disease. The ioPTH group had more conversions to a bilateral exploration (bilateral neck exploration [BNE]) (3.7% vs 13%, P = .024). In the MIRP group, no patients were found to have MGD. In the ioPTH group, 7 patients with double adenomas and 6 patients with MGD were found (0 vs 13, P = .0028).
CONCLUSIONS
ioPTH facilitates successful minimally invasive parathyroidectomy (MIP) when compared with MIRP and provides cure rates similar to BNE.
背景
本研究旨在确定微创放射性导向甲状旁腺切除术（MIRP）和术中甲状旁腺激素导向甲状旁腺切除术（ioPTH）在原发性甲状旁腺功能亢进症（PHPT）中的中期结果是否相当。
方法
对 25 个月内接受甲状旁腺切除术治疗 PHPT 的 244 例患者进行了回顾性研究。纳入接受 MIRP 或 ioPTH 引导甲状旁腺切除术的患者。主要结果是持续性疾病。次要结果是转为双侧探查、并发症和多腺体疾病（MGD）。
结果
MIRP 组有 1 例患者和无 ioPTH 患者存在持续性疾病。ioPTH 组有更多的患者转为双侧颈探查（BNE）（3.7%比 13%，P=0.024）。在 MIRP 组中，没有发现 MGD 患者。在 ioPTH 组中，发现 7 例双腺瘤和 6 例 MGD 患者（0 比 13，P=0.0028）。
结论
与 MIRP 相比，ioPTH 有利于成功的微创甲状旁腺切除术（MIP），并提供与 BNE 相似的治愈率。
Zotero 插件