Parathyroidectomy for primary hyperparathyroidism: The results of a single institution
Yıl: 2019 Cilt: 26 Sayı: 10 Sayfa Aralığı: 2423 - 2426 Metin Dili: İngilizce İndeks Tarihi: 22-09-2020
Parathyroidectomy for primary hyperparathyroidism: The results of a single institution
Öz: Aim: Prımary hyperparathyroidism (PHPT) is a clinical entity characterized by an excess synthesis of parathormone due to one ormore autonomic parathyroid gland. The present study aims to evaluate the outcomes of parathyroidectomies performed due toPHPT.Material and Methods: The results of 52 parathyroidectomies performed due to PHPT between September 2014 and October 2018were retrospectively evaluated for demographic, clinical, imaging and pathologic characteristics.Results: Fifty-two patients with primary hyperparathyroidism were included in the study. The mean age of the patients was50±14.5 years. Forty-three (82.9%) patients were female and 9 (17.4%) were male. The most common complaints at admissionwere generalized muscle and bone pain in 13 patients (15.3%). In 2 patients (3.8%) osteoporosis and another 2 (3.8%) patients,nephrolithiasis was identified. Thirty- five (67.3%) patients had no complaints. The mean preoperative calcium level was 11.21±0.88mg/dl. Mean preoperative phosphate level was 2.58±0.72 mg/ dl. Mean preoperative parathormone level was 278.65±317.67 pg/ml.Technetium 99m-sestamibi scintigraphy was obtained for 41 patients. Cervical ultrasonography was performed in 43 patients. Thesurgical localization of the parathyroid adenoma showed that the accuracy of ultrasonography was 60.4% whereas the accuracyof Technetium 99m-sestamibi scintigraphy was 80.4%. Three of the 12 (25%) patients with no localization in ultrasonography hadparathyroid hyperplasia as the pathologic diagnosis. There were two patients in whom ultrasonography and scintigraphy couldnot localize the pathologic parathyroid tissue and all of them (100%) were found to have parathyroid hyperplasia as the pathologicevaluation. Pathologic evaluation of the surgical specimens showed that there was adenoma in 40 patients (76.9%), hyperplasiain 5 (9.6%), normal parathyroid tissue in 5 (9.6%), tumor with undetermined biologic potential in 1 patient (1.9%) and adenomatousparathyroid tissue in 1 patient (1.9%). In fifteen patients (28.8%) concomitant total thyroidectomy, right lobectomy in 7 patients(13.4%)and left lobectomy in 4 patients (7.6%) were performed.Conclusion: Parathyroid adenoma can be localized in places other than the expected locations; despite the advances in imagingtechnologies. Surgeons experience and accurate localization before the operation are important for a successful parathyroidoperation. If scintigraphy and ultrasonography cannot localize the pathologic parathyroid tissue, hyperplasia should be suspected.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Kocakuşak A, Şentürk O, Sunar H. Surgical treatment and results in primary hyperparathyroidism. SDÜ Tıp Fakültesi Dergisi 2001;8:10-6.
- 2. Yılmaz C. Parathyroid diseases and surgery 3rd edition. İstanbul, Nobel Tıp Kitabevleri 2005;457-95.
- 3. Felger EA, Kandil E. Primary hyperparathyroidism. Otolaryngol Clin North Am 2010;43:417-32.
- 4. Çerçi C, Süreyya S, Süslü H, et al. Detection of atypically located parathyroid adenoma with gamma probe a case report. SDÜ Tıp Fakültesi Dergisi 2007;14:33-37.
- 5. Callender GG, Udelsman R. Surgery for primary hyperparathyroidism. Cancer 2014;120:3602-16.
- 6. Uludağ M, Aygün N. Primary Hyperparathyroidism: Current Status of Clinical and Biochemical Findings. Ş.E.E.A.H. Tıp Bülteni 2016;50:171-80.
- 7. Tas Ş. Retrospective Evaluation of Parathyroid Surgery in Our Clinic. Anatol J Clin Investig 2015;9:117-20.
- 8. Vignali E, Viccica G, Diacinti D, et al. Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 2009; 94: 2306-12.
- 9. Wermers RA, Khosla S, Atkinson EJ, et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993-2001: an update on the changing epidemiology of the disease. J Bone Miner Res 2006;21:171-7.
- 10. Chen H. Surgery for primary hyperparathyroidism: what is the best approach? Ann Surg. 2002 Nov;236:5523.
- 11. Erikoğlu M. Surgical approach in primary hyperparathyroidism and causes of failure in parathyroid surgery. Endokrinolojide Diyalog 2018; 15:1-5.
- 12. McHenry CR, Shi HH. Can parathyroid hyperplasia be predicted preoperatively? Am J Surg 2018;215:389- 92.
- 13. Kotan Ç, Kösem M, Özen S, et al. Number and localization anomalies of parathyroid glands. Van Tıp Dergisi 2001;8:97-101.
- 14. Dirican A, Yönder H, Karakaş S, et al. Our clinical and surgical experience in parathyroid adenomas. Endokrinolojide Diyalog 2014; 11:61-5.
- 15. Kutlutürk K, Otan E, Yağcı MA, et al. Thyroid pathologies associated with primary hyperparathyroidism: High thyroid papillary microcarcinoma ratio. Ulusal Cer Derg 2014; 30:125-8.
- 16. Çaycı M, Karahan Ö, Eryılmaz MA, et al. Factors affecting the development of parathyroid surgery. Ulusal Cerrahi Dergisi 2011;27:98-102.
APA | Gonultas F, IŞIK B (2019). Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. , 2423 - 2426. |
Chicago | Gonultas Fatih,IŞIK Burak Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. (2019): 2423 - 2426. |
MLA | Gonultas Fatih,IŞIK Burak Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. , 2019, ss.2423 - 2426. |
AMA | Gonultas F,IŞIK B Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. . 2019; 2423 - 2426. |
Vancouver | Gonultas F,IŞIK B Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. . 2019; 2423 - 2426. |
IEEE | Gonultas F,IŞIK B "Parathyroidectomy for primary hyperparathyroidism: The results of a single institution." , ss.2423 - 2426, 2019. |
ISNAD | Gonultas, Fatih - IŞIK, Burak. "Parathyroidectomy for primary hyperparathyroidism: The results of a single institution". (2019), 2423-2426. |
APA | Gonultas F, IŞIK B (2019). Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. Annals of Medical Research, 26(10), 2423 - 2426. |
Chicago | Gonultas Fatih,IŞIK Burak Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. Annals of Medical Research 26, no.10 (2019): 2423 - 2426. |
MLA | Gonultas Fatih,IŞIK Burak Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. Annals of Medical Research, vol.26, no.10, 2019, ss.2423 - 2426. |
AMA | Gonultas F,IŞIK B Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. Annals of Medical Research. 2019; 26(10): 2423 - 2426. |
Vancouver | Gonultas F,IŞIK B Parathyroidectomy for primary hyperparathyroidism: The results of a single institution. Annals of Medical Research. 2019; 26(10): 2423 - 2426. |
IEEE | Gonultas F,IŞIK B "Parathyroidectomy for primary hyperparathyroidism: The results of a single institution." Annals of Medical Research, 26, ss.2423 - 2426, 2019. |
ISNAD | Gonultas, Fatih - IŞIK, Burak. "Parathyroidectomy for primary hyperparathyroidism: The results of a single institution". Annals of Medical Research 26/10 (2019), 2423-2426. |