El-Husseini Amr, Wang Kevin, Edon Adeleye Annick, Sawaya B Peter
Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, KY, USA.
Division of Nephrology, Mansoura University, Mansoura, Egypt.
Semin Dial. 2017 Sep;30(5):385-389. doi: 10.1111/sdi.12632. Epub 2017 Jul 5.
Despite advancements in the medical management of secondary hyperparathyroidism, parathyroidectomy is still necessarily in some patients. However, patients' selection, optimal surgical intervention and long-term outcome are still not well-defined and very challenging for the practicing nephrologists. In this manuscript we will attempt to answer several questions related to parathyroidectomy in dialysis patients. We will discuss the indications, the appropriate parathyroidectomy surgical techniques and current guidelines for parathyroidectomy. We will also discuss short- and long-term outcome and analyze the pros and cons of the procedure. It is readily apparent that the performance of parathyroidectomy in dialysis patients should be highly individualized.
尽管继发性甲状旁腺功能亢进的药物治疗取得了进展，但甲状旁腺切除术对某些患者而言仍是必要的。然而，患者的选择、最佳手术干预措施以及长期疗效仍未明确界定，这对执业肾病学家来说极具挑战性。在本手稿中，我们将尝试回答一些与透析患者甲状旁腺切除术相关的问题。我们将讨论手术指征、合适的甲状旁腺切除手术技术以及当前的甲状旁腺切除指南。我们还将讨论短期和长期疗效，并分析该手术的利弊。显而易见，透析患者甲状旁腺切除术的实施应高度个体化。
