지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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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.91 No.3
- 발행연도
- 2016.9
- 수록면
- 97 - 103 (7page)
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초록· 키워드
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Purpose: The aim of this study was to determine whether focused or complete parathyroidectomy was more appropriate and to compare follow-up data in primary hyperparathyroidism (PHPT).
Methods: We retrospectively analyzed 225 operations for PHPT at Yonsei University Health System between 2000 and 2012. After excluding 93 patients, the remaining 132 were divided into 2 groups: those who underwent focused parathyroidectomy (FP) and those who underwent conventional parathyroidectomy (CP). We compared clinicopathological features; preoperative calcium, parathyroid hormone (PTH), phosphorus, vitamin D, 24-hour urine calcium, and alkaline phosphatase levels; postoperative calcium and PTH levels; pathologic diagnosis; multiplicity; and results of a localization study between the 2 groups.
Results: There was no significant difference in the rates of development of postoperative persistent hyperparathyroidism (1/122 FP patients and 1/10 CP patients) between the 2 groups due to a technical reason (FP 0.8% vs. CP 10.0%, P = 0.146). Multiglandular disease (MGD) was uncommon in all cases (6 of 132, 4.5%). All MGD cases were diagnosed using a preoperative localization study. Sestamibi scan and ultrasonography sensitivity were 94.2% and 90.2%, respectively.
Conclusion: We suggest that FP is appropriate in PHPT, except in cases of MGD if detected before the operation using preoperative imaging. Knowledge of hereditary PHPT and improved preoperative localization studies, such as high-resolution ultrasonography, contributed to the decision to perform FP rather than CP in all cases of unilateral results of the localizing study.
Methods: We retrospectively analyzed 225 operations for PHPT at Yonsei University Health System between 2000 and 2012. After excluding 93 patients, the remaining 132 were divided into 2 groups: those who underwent focused parathyroidectomy (FP) and those who underwent conventional parathyroidectomy (CP). We compared clinicopathological features; preoperative calcium, parathyroid hormone (PTH), phosphorus, vitamin D, 24-hour urine calcium, and alkaline phosphatase levels; postoperative calcium and PTH levels; pathologic diagnosis; multiplicity; and results of a localization study between the 2 groups.
Results: There was no significant difference in the rates of development of postoperative persistent hyperparathyroidism (1/122 FP patients and 1/10 CP patients) between the 2 groups due to a technical reason (FP 0.8% vs. CP 10.0%, P = 0.146). Multiglandular disease (MGD) was uncommon in all cases (6 of 132, 4.5%). All MGD cases were diagnosed using a preoperative localization study. Sestamibi scan and ultrasonography sensitivity were 94.2% and 90.2%, respectively.
Conclusion: We suggest that FP is appropriate in PHPT, except in cases of MGD if detected before the operation using preoperative imaging. Knowledge of hereditary PHPT and improved preoperative localization studies, such as high-resolution ultrasonography, contributed to the decision to perform FP rather than CP in all cases of unilateral results of the localizing study.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
[학술지(정기간행물)] - Adler JT. / 2010 / New trends in parathyroid surgery / Curr Probl Surg 47 : 958 ~ 1017
[학술지(정기간행물)] - Macfarlane DP. / 2011 / Should ‘mild primary hyper para thyroidism’ be reclassified as ‘insidious’ : is it time to reconsider? / Clin Endocrinol(Oxf) 75 : 730 ~ 737
[학술지(정기간행물)] - Chen H. / 1999 / Outpatient minimally invasive parathyroidectomy : a combination of sestamibi-SPECT locali zation, cervical block anesthesia, and intraopera tive parathyroid hormone assay / Surgery 126 : 1016 ~ 1021
[학술지(정기간행물)] - Flynn MB. / 2000 / Minimally invasive radioguided parathyroidectomy / J Am Coll Surg 191 : 24 ~ 31
[학술지(정기간행물)] - Nagar S. / 2012 / Outcomes analysis of intraoperative ad juncts during minimally invasive para thy roidectomy for primary hyper parathyroidism / Am J Surg 203 : 177 ~ 181
[학술지(정기간행물)] - Macfarlane DP. / 2011 / Should ‘mild primary hyper para thyroidism’ be reclassified as ‘insidious’ : is it time to reconsider? / Clin Endocrinol(Oxf) 75 : 730 ~ 737
[학술지(정기간행물)] - Chen H. / 1999 / Outpatient minimally invasive parathyroidectomy : a combination of sestamibi-SPECT locali zation, cervical block anesthesia, and intraopera tive parathyroid hormone assay / Surgery 126 : 1016 ~ 1021
[학술지(정기간행물)] - Flynn MB. / 2000 / Minimally invasive radioguided parathyroidectomy / J Am Coll Surg 191 : 24 ~ 31
[학술지(정기간행물)] - Nagar S. / 2012 / Outcomes analysis of intraoperative ad juncts during minimally invasive para thy roidectomy for primary hyper parathyroidism / Am J Surg 203 : 177 ~ 181
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UCI(KEPA) : I410-ECN-0101-2017-514-001094311