Palmer J A, Rosen I B
Am J Surg. 1982 Oct;144(4):406-10. doi: 10.1016/0002-9610(82)90412-3.
The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroidectomy. Reoperative surgery is difficult and although it is successful in approximately 70 to 80 percent of patients, it is associated with a significant morbidity which includes persistent hypercalcemia, hypoparathyroidism, and nerve injury. Reoperative parathyroid surgery should be done in specialized centers where the sophisticated methods of preoperative localization and surgeons experienced in this field are available.
初次手术不成功所造成的困难通常可以通过选择经验丰富的外科医生、识别四个甲状旁腺以及选择性切除明显异常的甲状旁腺组织来避免。患有多发性内分泌腺瘤病或家族性甲状旁腺功能亢进症的患者应进行甲状旁腺次全切除术。再次手术难度较大，尽管约70%至80%的患者手术成功，但会有明显的发病率，包括持续性高钙血症、甲状旁腺功能减退和神经损伤。再次甲状旁腺手术应在具备术前精细定位方法且有该领域经验丰富的外科医生的专业中心进行。
