Heslinga J M
Neth J Surg. 1981 Oct;33(4):200-5.
A series of 217 operations performed for primary hyperparathyroidism between 1965 and 1978, was studied to evaluate the peroperative findings and to assess the results of surgical treatment. There was a greater incidence in women than in men, a ratio of 2.5:1. Although occurring at any age, the incidence was higher for women over the age of 45. During all 217 neck explorations it was attempted to identify all parathyroid glands. In 89% of cases three or more glands were found. Of the 746 glands, 74% were situated normally and 12% were found inside the thymus. Histological examination confirmed hyperplasia in 50% of the patients, but one enlarged gland was found in each of 155 patients (70%). This shows a discrepancy based on microscopic findings by the pathologist and macroscopic findings by the surgeon concerned. Until today it has been our policy to remove the enlarged gland and to biopsy at least one other normally sized gland. Only when three or more glands are involved, a subtotal parathyroidectomy is recommended. The success rate of our primary operation is 96%. Complications due to severe hypocalcaemia or permanent vocal cord palsy have not been observed.
对1965年至1978年间因原发性甲状旁腺功能亢进症而进行的217例手术进行了研究，以评估术中发现并评估手术治疗的结果。女性的发病率高于男性，比例为2.5:1。虽然该疾病在任何年龄均可发生，但45岁以上女性的发病率更高。在所有217次颈部探查中，均试图识别所有甲状旁腺。在89%的病例中发现了三个或更多的腺体。在746个腺体中，74%位置正常，12%位于胸腺内。组织学检查证实50%的患者存在增生，但在155例患者（70%）中各发现一个增大的腺体。这显示了病理学家的微观发现与相关外科医生的宏观发现之间存在差异。直到今天，我们的策略一直是切除增大的腺体并对至少一个其他正常大小的腺体进行活检。仅当三个或更多腺体受累时，才建议进行甲状旁腺次全切除术。我们初次手术的成功率为96%。未观察到因严重低钙血症或永久性声带麻痹引起的并发症。
