Division of Visceral Surgery, Department of General Surgery, Medical University Vienna, Vienna, Austria.
Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Langenbecks Arch Surg. 2023 Apr 13;408(1):150. doi: 10.1007/s00423-023-02819-2.
EUROCRINE is an endocrine surgical register documenting diagnostic processes, indication for surgical treatment, surgical procedures, and outcomes. The purpose was to analyse data for PHPT in German speaking countries regarding differences in clinical presentation, diagnostic workup, and treatment.
All operations for PHPT performed from 07/2015 to 12/2019 were analysed.
Three thousand two hundred ninety-one patients in Germany (9 centres; 1762 patients), Switzerland (16 centres; 971 patients) and Austria (5 centres; 558 patients) were analysed. Hereditary disease was seen in 36 patients in Germany, 16 patients in Switzerland and 8 patients in Austria. In sporadic disease before primary operation, PET-CT showed the highest sensitivity in all countries. In re-operations, CT and PET-CT achieved the highest sensitivities. The highest sensitivity of IOPTH was seen in Austria (98.1%), followed by Germany (96.4%) and Switzerland (91.3%). Operation methods and mean operative time reached statistical significance (p<0.05). Complication rates are low. Overall, 656 (19.9%) patients were asymptomatic; the remainder showed bone manifestations, kidney stones, fatigue and/or neuropsychiatric symptoms.
Early postoperative normocalcaemia ranged between 96.8 and 97.1%. Complication rates are low. PET-CT had the highest sensitivity in all three countries in patients undergoing primary operation as well as in Switzerland and Austria in patients undergoing re-operation. PET-CT could be considered a first-line preoperative imaging modality in patients with inconclusive ultrasound examination. The EUROCRINE registry is a beneficial and comprehensive data source for outcome analysis of endocrine procedures on a supranational level.
EUROCRINE 是一个内分泌外科登记处，记录诊断过程、手术治疗指征、手术程序和结果。目的是分析德语国家 PHPT 的数据，了解临床表型、诊断评估和治疗方面的差异。
分析了 2015 年 7 月至 2019 年 12 月期间进行的所有 PHPT 手术。
在德国（9 个中心；1762 例患者）、瑞士（16 个中心；971 例患者）和奥地利（5 个中心；558 例患者）分析了 3291 例患者。德国有 36 例遗传性疾病，瑞士有 16 例，奥地利有 8 例。在初次手术前的散发性疾病中，PET-CT 在所有国家的敏感性最高。在再次手术中，CT 和 PET-CT 的敏感性最高。IOPTH 的敏感性最高的是奥地利（98.1%），其次是德国（96.4%）和瑞士（91.3%）。手术方法和平均手术时间具有统计学意义（p<0.05）。并发症发生率低。总的来说，656 例（19.9%）患者无症状；其余患者表现为骨表现、肾结石、疲劳和/或神经精神症状。
术后早期血钙正常范围在 96.8%至 97.1%之间。并发症发生率低。在初次手术和瑞士、奥地利再次手术中，PET-CT 在所有三个国家的敏感性最高。在超声检查结果不确定的患者中，PET-CT 可作为一线术前影像学检查方法。EUROCRINE 登记处是在跨国层面上分析内分泌手术结果的有益且全面的数据源。
