지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.89 No.3
- 발행연도
- 2015.8
- 수록면
- 111 - 116 (6page)
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초록· 키워드
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Purpose: The improvement of intraoperative parathyroid hormone (IOPTH) assay and localization studies has enabled a minimally invasive parathyroidectomy (MIP) in primary hyperparathyroidism (pHPT). The aim of this study is to analyze the demographics, clinical presentations, and surgical outcomes of the pHPT patients who received surgical management with versus without IOPTH.
Methods: Analysis of a database was performed on 53 patients who underwent parathyroidectomy for pHPT from 2004 to 2013. Preoperative localization was done by both sestamibi scan and ultrasonography. We divided the patients into two groups (without IOPTH versus with IOPTH) and analyzed the surgical outcomes statistically between two groups.
Results: The concordance rate of Technetium 99m sestamibi scan and ultrasonography was 73.6% and 90.6%, respectively. The overall cure rate of group 1 (without IOPTH) was 94.9% and that of group 2 (with IOPTH) was 100%. The decline of PTH at postoperative 5 minutes and 10 minutes was 75.2% ± 14.9% and 84.9% ± 8.6% in cured patients. On the other hand, that of noncured patients at 5 minutes and 10 minutes was 17.2% ± 9.7% and 8.2% ± 2.2%. There was a significant difference in the drop rate of IOPTH between cured and persistent patients (P < 0.01). Pathological examination showed adenoma in 41 of 53 patients (77.4%) and hyperplasia in 10 of 53 patients (18.9%).
Conclusion: Even though the localization studies were successful, IOPTH monitoring is essential to avoid a surgical failure in MIP.
Methods: Analysis of a database was performed on 53 patients who underwent parathyroidectomy for pHPT from 2004 to 2013. Preoperative localization was done by both sestamibi scan and ultrasonography. We divided the patients into two groups (without IOPTH versus with IOPTH) and analyzed the surgical outcomes statistically between two groups.
Results: The concordance rate of Technetium 99m sestamibi scan and ultrasonography was 73.6% and 90.6%, respectively. The overall cure rate of group 1 (without IOPTH) was 94.9% and that of group 2 (with IOPTH) was 100%. The decline of PTH at postoperative 5 minutes and 10 minutes was 75.2% ± 14.9% and 84.9% ± 8.6% in cured patients. On the other hand, that of noncured patients at 5 minutes and 10 minutes was 17.2% ± 9.7% and 8.2% ± 2.2%. There was a significant difference in the drop rate of IOPTH between cured and persistent patients (P < 0.01). Pathological examination showed adenoma in 41 of 53 patients (77.4%) and hyperplasia in 10 of 53 patients (18.9%).
Conclusion: Even though the localization studies were successful, IOPTH monitoring is essential to avoid a surgical failure in MIP.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
[학술지(정기간행물)] - Marcocci C. / 2011 / Clinical practice : primary hyperparathyroidism / N Engl J Med 365 : 2389 ~ 2397
[학술지(정기간행물)] - 이승원 / 2006 / 부갑상선 기능항진증을 동반한 부갑상선 선종에 대한 임상적 고찰 / 대한이비인후과학회지 두경부외과학 49 (1) : 72 ~ 78
[학술지(정기간행물)] - Lundgren E. / 2001 / Increased cardiovascular mortality and normalized serum calcium in patients with mild hypercalcemia followed up for 25 years / Surgery 130 : 978 ~ 985
[학술지(정기간행물)] - Ollila DW. / 2006 / Successful minimally invasive parathyroidectomy for primary hyperparathyroidism without using intraoperative parathyroid hormone assays / Am J Surg 191 : 52 ~ 56
[학술지(정기간행물)] - Bilezikian JP. / 2009 / Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism : summary statement from the third international workshop / J Clin Endocrinol Metab 94 : 335 ~ 339
[학술지(정기간행물)] - 이승원 / 2006 / 부갑상선 기능항진증을 동반한 부갑상선 선종에 대한 임상적 고찰 / 대한이비인후과학회지 두경부외과학 49 (1) : 72 ~ 78
[학술지(정기간행물)] - Lundgren E. / 2001 / Increased cardiovascular mortality and normalized serum calcium in patients with mild hypercalcemia followed up for 25 years / Surgery 130 : 978 ~ 985
[학술지(정기간행물)] - Ollila DW. / 2006 / Successful minimally invasive parathyroidectomy for primary hyperparathyroidism without using intraoperative parathyroid hormone assays / Am J Surg 191 : 52 ~ 56
[학술지(정기간행물)] - Bilezikian JP. / 2009 / Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism : summary statement from the third international workshop / J Clin Endocrinol Metab 94 : 335 ~ 339
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