Knight R, Ratzer E R, Fenoglio M E, Moore J T
Department of Surgery Education, Saint Joseph Hospital, Denver, Colorado 80218, USA.
J Am Coll Surg. 1997 Nov;185(5):481-5. doi: 10.1016/s1072-7515(97)00096-3.
Most abnormal parathyroid glands can be removed through a standard cervical incision; even those in the superior mediastinum. Those located in certain areas of the mediastinum, for example posteriorly or in the aortopulmonic window, historically have required excision through a median sternotomy or thoracotomy. Angioablation is a nonsurgical alternative to management of these lesions.
We present two case reports of mediastinal parathyroid adenomas that were excised thoracoscopically, and review the literature regarding the management of mediastinal parathyroid adenomas.
Both patients who underwent precise localization and thoracoscopic excision of their mediastinal parathyroid adenomas had resolution of their hypercalcemia with minimal associated morbidity and shortened recovery periods.
We suggest that thoracoscopic excision of mediastinal parathyroid adenomas is the better means of controlling hypercalcemia secondary to parathyroid adenoma in those patients considered for either median sternotomy, thoracotomy or angiographic ablation where the exact location of the lesion can be established preoperatively.
大多数异常甲状旁腺可通过标准颈部切口切除，即使是位于上纵隔的甲状旁腺。位于纵隔某些区域的甲状旁腺，如后方或主肺动脉窗区域，以往通常需要通过正中胸骨切开术或开胸术切除。血管消融术是治疗这些病变的一种非手术替代方法。
我们报告两例经胸腔镜切除纵隔甲状旁腺腺瘤的病例，并回顾有关纵隔甲状旁腺腺瘤治疗的文献。
两名接受纵隔甲状旁腺腺瘤精确定位及胸腔镜切除的患者，高钙血症均得到缓解，相关并发症极少，恢复时间缩短。
我们认为，对于考虑行正中胸骨切开术、开胸术或血管造影消融术且术前可确定病变确切位置的患者，胸腔镜切除纵隔甲状旁腺腺瘤是控制甲状旁腺腺瘤继发高钙血症的更佳方法。
