基于术前诊断和手术选择的术中甲状旁腺激素剂量在原发性甲状旁腺功能亢进症中的应用。
The utility of intraoperative PTH dosage in primary hyperparathyroidism based on preoperative diagnosis and surgical choice.
作者信息
Scipioni Federica, Fagni Niccolò, Borrelli Andrea, Coppola Angela, Roviello Franco, Petrucci Alvaro, Sarno Antonio, Giordano Alessio, Cantafio Stefano, Feroci Francesco
机构信息
Department of Surgery, Santo Stefano Hospital, ASL Toscana Centro, Prato, Italy.
Unit of Nuclear Medicine, Santo Stefano Hospital, ASL Toscana Centro, Prato, Italy.
出版信息
Minerva Surg. 2023 Feb;78(1):1-10. doi: 10.23736/S2724-5691.22.09474-6. Epub 2022 Mar 25.
BACKGROUND
The aim of this study was to evaluate the impact of the intraoperative PTH (ioPTH) monitoring in the success of parathyroidectomy based on the concordant or indeterminate preoperative imaging studies of localization and the performed surgical choices.
METHODS
Fourthy-seven patients who received parathyroidectomy operations were divided in four groups: concordance of the imaging and ioPTH, concordance of the imaging and no ioPTH, indeterminate imaging and ioPTH and indeterminate imaging and no ioPTH.
RESULTS
Overall, patients in whom ioPTH monitoring was not performed were healed in 89.47% of cases, while the percentage of recovery in patients receiving ioPTH was 85.71%. There were no differences in the changes in strategy or in the cure rates with the use of ioPTH.
CONCLUSIONS
No significant differences were found, independently from the preoperative imaging agreement, in either the cure rate or in the change of intraoperative strategy using the ioPTH dosage.
背景
本研究的目的是基于术前定位成像研究的一致性或不确定性以及所采取的手术选择，评估术中甲状旁腺激素（ioPTH）监测对甲状旁腺切除术成功的影响。
方法
47例行甲状旁腺切除术的患者被分为四组：成像与ioPTH一致组、成像与无ioPTH一致组、成像不确定与ioPTH组以及成像不确定与无ioPTH组。
结果
总体而言，未进行ioPTH监测的患者89.47%治愈，而接受ioPTH监测的患者恢复率为85.71%。使用ioPTH时，策略变化或治愈率方面无差异。
结论
无论术前成像是否一致，在治愈率或使用ioPTH剂量改变术中策略方面均未发现显著差异。
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