Edis A J, van Heerden J A, Scholz D A
Surgery. 1979 Sep;86(3):462-9.
Analysis of the long-term results of subtotal parathyroidectomy in patients with primary chief cell hyperplasia provides evidence that refutes the recent assertion that such treatment is often ineffective. With the use of rigid criteria, 55 patients with unequivocal chief cell hyperplasia were culled from 1,576 patients who had been operated on for primary hyperparathyroidism at the Mayo Clinic between July, 1959, and July, 1976. Follow-up information, including serum levels of calcium, was obtained for all patients up to at least July, 1977. Follow-up for surviving patients ranged from 1 year to 17 years (average, 3.9 years). Seven patients (13%) were not cured by subtotal parathyroidectomy and were left with persistent hyperparathyroidism after operation, presumably because a supernumerary gland was overlooked. However, not a single patient experienced recurrent hyperparathyroidism during the 213 patient-years of follow-up. In only three patients (5%) did permanent hypoparathyroidism develop following operation. These results reaffirm the efficacy of subtotal parathyroidectomy for primary chief cell hyperplasia and call into serious question the recent advocacy of total parathyroidectomy and autotransplantation of parathyroid tissue in these cases.
对原发性主细胞增生患者行甲状旁腺次全切除术的长期结果分析提供了证据，反驳了近期认为这种治疗常常无效的断言。采用严格标准，从1959年7月至1976年7月在梅奥诊所因原发性甲状旁腺功能亢进接受手术的1576例患者中筛选出55例明确诊断为主细胞增生的患者。获取了所有患者直至至少1977年7月的随访信息，包括血清钙水平。存活患者的随访时间为1年至17年（平均3.9年）。7例患者（13%）未通过甲状旁腺次全切除术治愈，术后仍存在持续性甲状旁腺功能亢进，推测是因为一个额外的腺体被遗漏。然而，在213患者年的随访期间，没有一例患者出现复发性甲状旁腺功能亢进。仅3例患者（5%）术后发生永久性甲状旁腺功能减退。这些结果再次肯定了甲状旁腺次全切除术治疗原发性主细胞增生的有效性，并对近期在这些病例中主张行甲状旁腺全切除术及甲状旁腺组织自体移植提出了严重质疑。
