Department of General and Endocrine Surgery School of Medicine with the Division of Dentistry in Zabrze Medical University of Silesia, Katowice, Poland, Batorego 15, 41-902 Bytom, Poland.
Endokrynol Pol. 2018;69(2):163-167. doi: 10.5603/EP.2018.0020.
Evaluation of the results of surgical treatment in patients with hyperparathyroidism related to MEN syndrome MATERIALS AND METHODS: The group of three women and two men aged between 17 and 72 years ( av. 38.6) with MEN- related hyperparathyroidism within 419 patients were operated between 2010-2016. MEN1 syndrome was diagnosed in four patients and MEN2 only once. Pre- and postoperative results of PTH levels and serum calcium values were compared.
The mean preoperative serum PTH level was 215,56 pg/ml, whereas calcium concentration was 1.40 mmol/l. Three Patients with MEN1 syndrome had three and two thirds of parathyroid gland taken, and one had a single parathyroid gland excised with biopsy of the rest glands performed. A patient with MEN2 syndrome had one parathyroid gland excised. Postoperatively, we reported decreased secretion of both PTH (a mean serum PTH concentration 6.72 pg/ml), and serum calcium concentration 1.11 mmol/l. One patient (25%) with MEN 1 developed recurrent hyperparathyroidism after five years from the surgery. The patient was reoperated. The rest of the parathyroid gland was removed with an implantation into separated muscle pockets in the anterior forearm muscles.
评估与 MEN 综合征相关的甲状旁腺功能亢进症患者的手术治疗结果
本研究组共纳入了 419 例患者，其中有 3 名女性和 2 名男性患者，年龄在 17 岁至 72 岁之间（平均年龄 38.6 岁），患有与 MEN 相关的甲状旁腺功能亢进症。在这 5 名患者中，4 名患者诊断为 MEN1 综合征，1 名患者诊断为 MEN2 综合征。对比了这些患者手术前后甲状旁腺激素（PTH）水平和血清钙值的变化。
术前患者平均血清 PTH 水平为 215.56 pg/ml，血钙浓度为 1.40 mmol/l。3 名 MEN1 综合征患者切除了 3 个半甲状旁腺，1 名患者切除了单个甲状旁腺，同时对其余甲状旁腺进行了活检。1 名 MEN2 综合征患者切除了 1 个甲状旁腺。术后，我们发现 PTH（血清 PTH 浓度平均为 6.72 pg/ml）和血清钙浓度（1.11 mmol/l）均有所下降。1 名 MEN1 综合征患者（25%）在手术后 5 年出现复发性甲状旁腺功能亢进症，再次接受手术治疗。将剩余的甲状旁腺切除，并植入前臂肌肉的分离肌肉袋中。
