Surgical treatment of primary hyperparathyroidism due to parathyroid tumor: A 15-year experience

Abstract

Abstract. The aim of this study was to highlight our experience over a 15-year period in dealing with primary hyperparathyroidism (PHPT) due to a parathyroid tumor. Parathyroidectomy is the standard therapy for patients with PHPT. Our study included all patients with PHPT treated by parathyroidectomy at the Affiliated Cancer Hospital of Zhengzhou University, China. Between 1998 and 2013, a total of 107 patients were recruited. Their clinical data, presentation, laboratory examinations, imageological diagnoses and surgical approaches were analyzed retrospectively. Eighty-four cases (78.5%) were followed up. During a median follow-up period of 5.7 years, a total of 80 patients were without recurrence and metastasis. The main symptoms of PHPT patients were palpable neck mass, joint pains and pathological fracture. The high levels of preoperative parathyroid hormone (PTH) and serum calcium in PHPT patients decreased to below the normal upper limit within 3 days of surgery. The sensitivity of neck ultrasonography, sestamibi scanning, CT, MRI and the combination of three or four types of test were 86.0%, 90.4%, 80.8%, 79.6% and 96.1%, respectively. A 50% or greater drop in PTH levels within 20 min compared with the highest PTH levels before surgery occurred in 95/107 cases (88.8%). Transient hypocalcemia was the most common surgical complication. The ultra sonography and sestamibi scan is the most effective examination for parathyroid tumor. The 20 min PTH measurement appears to be extremely useful, and avoids unnecessary bilateral exploration.

Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

“… 44 Therefore, accurate preoperative positioning of the parathyroid gland is also important. Color Doppler ultrasound, nuclide imaging, computed tomography, and other comprehensive examinations of the parathyroid gland can improve the accuracy and sensitivity of localization, 45 providing a reference and guidance for surgical methods.…”

Diagnosis and treatment of primary hyperparathyroidism with pathological fracture of the limbs: A retrospective observational study

“…Parathyroidectomy is the gold standard treatment for PHPT patients, with a surgical cure rate of 95% to 98%, as it can effectively inhibit bone resorption, and reduce the incidence of complications, such as fractures. [7][8][9][10][11] The incidence of PHPT ranges from 0.4 to 82 cases per 100,000. The incidence of pathological fractures associated with PHPT is even lower, accounting for 16.4% of patients with PHPT.…”

“…Parathyroidectomy is the gold standard treatment for PHPT patients, with a surgical cure rate of 95% to 98%, as it can effectively inhibit bone resorption, and reduce the incidence of complications, such as fractures. [7–11]…”

Ventilación mecánica no invasiva vs. Ventilación mecánica invasiva para la asistencia respiratoria de cuidados anestésicos: Postiroidectomía

“…Las complicaciones cardíacas son igualmente desafiantes, asi como la posibilidad de que la cirugía se extienda al espacio retrosternal. Además, siempre existe un riesgo potencial de hemorragia no controlada de una lesión vascular ya que muchos vasos importantes se encuentran en las proximidades de la glándula tiroides y, a veces la lesión a los propios vasos tiroideos [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] .…”