Katz A D, Hopp D
Am J Surg. 1982 Oct;144(4):411-5. doi: 10.1016/0002-9610(82)90413-5.
Three hundred thirty-eight consecutive parathyroidectomies for hyperparathyroidism were performed over a 22 year period. There were 53 dialysis patients (31 male and 22 female), 285 patients (165 female and 120 male) with primary hyperparathyroidism, 55 patients (19 percent) with parathyroid hyperplasia, and 230 patients with 236 parathyroid adenomas. The location of the adenomas were right upper in 57, right lower in 59, left upper in 60, and left lower in 60. Forty-three patients of the last 194 operated on had histories of childhood head and neck irradiation (21.6 percent), 34 patients (79.6 percent) had associated thyroid disease, and there were 10 with thyroid carcinomas. In the 285 patients, 54 percent had thyroid disease, and 18 had thyroid carcinomas. Twenty-three patients required reoperation for persistent or recurrent hypercalcemia, and 19 neck reexplorations and 6 mediastinotomies were performed. The identification and biopsy as indicated of all four parathyroid glands at initial neck exploration would have prevented over 70 percent of reoperations.
在22年的时间里，连续进行了338例因甲状旁腺功能亢进症而实施的甲状旁腺切除术。其中有53例透析患者（31例男性和22例女性），285例原发性甲状旁腺功能亢进患者（165例女性和120例男性），55例（19%）甲状旁腺增生患者，以及230例患有236个甲状旁腺腺瘤的患者。腺瘤的位置分别为右上57个，右下59个，左上60个，左下60个。在最后接受手术的194例患者中，43例（21.6%）有儿童期头颈部放疗史，34例（79.6%）有相关甲状腺疾病，其中10例患有甲状腺癌。在285例患者中，54%有甲状腺疾病，18例患有甲状腺癌。23例患者因持续性或复发性高钙血症需要再次手术，共进行了19次颈部再次探查和6次纵隔切开术。在初次颈部探查时对所有四个甲状旁腺进行指示性识别和活检，可避免超过70%的再次手术。
