Wright Marie-Christine, Jensen Kelly, Mohamed Hossam, Drake Carolyn, Mohsin Khuzema, Monlezun Dominique, Alsaleh Nuha, Kandil Emad
Tulane University School of Medicine, New Orleans, LA, USA.
School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Gland Surg. 2017 Aug;6(4):368-374. doi: 10.21037/gs.2017.04.01.
Thyroid abnormalities have been found intraoperatively during parathyroidectomy and have resulted in concomitant thyroidectomy. The identification of concomitant disease is important prior to primary operation in order to minimize reoperations. This study investigates the incidence of concomitant primary hyperparathyroidism (PHPT) and thyroid nodular disease in patients undergoing thyroidectomy or parathyroidectomy.
We performed a retrospective review of prospectively gathered data for 621 patients who underwent thyroidectomy, parathyroidectomy, or both at Tulane Medical Center. Information obtained included initial referral, initial thyroid stimulating hormone (TSH), initial parathyroid hormone (PTH), fine needle aspiration (FNA) results, ultrasound results, type of operation performed, final diagnosis, and final pathology.
Among the 400 patients referred primarily for thyroid disease, 13.50% underwent a thyroidectomy and parathyroidectomy (PTX) simultaneously and 10.75% received a final diagnosis of thyroid and concomitant parathyroid disease. Among the 103 patients referred primarily for parathyroid disease, 26.21% underwent a PTX and thyroidectomy and 24.27% received a final diagnosis of both thyroid and parathyroid disease. Patients referred primarily for parathyroid disease were more likely to receive a final diagnosis of both parathyroid and thyroid disease and were more likely to undergo a combined operation.
Concomitant thyroid and parathyroid disease occur and preoperative analysis is important to avoid increased complications from reoperations.
在甲状旁腺切除术中已发现甲状腺异常，并导致了同期甲状腺切除术。在初次手术前识别合并疾病很重要，以便尽量减少再次手术。本研究调查了接受甲状腺切除术或甲状旁腺切除术患者中合并原发性甲状旁腺功能亢进症（PHPT）和甲状腺结节性疾病的发生率。
我们对在杜兰医学中心接受甲状腺切除术、甲状旁腺切除术或两者皆有的621例患者的前瞻性收集数据进行了回顾性分析。获得的信息包括初次转诊、初次促甲状腺激素（TSH）、初次甲状旁腺激素（PTH）、细针穿刺抽吸（FNA）结果、超声结果、所施行的手术类型、最终诊断和最终病理。
在最初因甲状腺疾病转诊的400例患者中，13.50%同时接受了甲状腺切除术和甲状旁腺切除术（PTX），10.75%最终诊断为甲状腺及合并甲状旁腺疾病。在最初因甲状旁腺疾病转诊的103例患者中，26.21%接受了PTX和甲状腺切除术，24.27%最终诊断为甲状腺和甲状旁腺疾病。最初因甲状旁腺疾病转诊的患者更有可能最终诊断为甲状旁腺和甲状腺疾病，并且更有可能接受联合手术。
甲状腺和甲状旁腺合并疾病存在，术前分析对于避免再次手术增加并发症很重要。
