Friedrich J, Krause U, Olbricht T, Eigler F W
Abteilung für Allgemeine Chirurgie, Universitätsklinikums Essen.
Zentralbl Chir. 1995;120(1):43-6.
Among 334 neck explorations for primary hyperparathyroidism (pHPT) between 1979 and 1993 120 (33.9%) thyroid operations were performed simultaneously. Histologic examination revealed 40 thyroid adenomas, 43 nodular goiters, 8 thyroiditis and 9 differentiated carcinomas. In 20 cases the indication was doubtful retrospectively, as evaluated by postoperative histology. Of the 9 carcinomas there were 4 small papillary, 3 papillary pT2 No Mo and 2 follicular pT2 No Mo. Perioperative morbidity of the simultaneous operations was not significantly increased compared to the parathyroid exploration alone. We conclude, that pre- and intraoperative thyroid examination should be performed in pHPT and decision for a simultaneous operation should be made generously.
在1979年至1993年间进行的334例原发性甲状旁腺功能亢进症(pHPT)颈部探查手术中,同时进行了120例(33.9%)甲状腺手术。组织学检查发现40例甲状腺腺瘤、43例结节性甲状腺肿、8例甲状腺炎和9例分化型癌。根据术后组织学评估,20例患者的手术指征回顾性地存疑。9例癌中,有4例微小乳头状癌、3例乳头状癌pT2 No Mo和2例滤泡状癌pT2 No Mo。与单纯甲状旁腺探查相比,同期手术的围手术期发病率没有显著增加。我们得出结论,对于pHPT患者,应在术前和术中进行甲状腺检查,并且对于同期手术的决定应更为宽松。