Changing Trends in Preoperative Localization and Surgical Techniques for the Treatment of Primary Hyperparathyroidism in a Single Tertiary Center

Jumyung Lee; Su-JIn Kim; Hyeong Won Yu; Young Jun Chai; June Young Choi; Kyu Eun Lee

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자료유형: 학술저널

저자정보: Jumyung Lee Su-JIn Kim Hyeong Won Yu Young Jun Chai June Young Choi Kyu Eun Lee

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제19권 제4호

발행연도: 2019.1

수록면: 126 - 135 (10page)

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Purpose: Primary hyperparathyroidism (PHPT) is caused by the oversecretion of parathyroid hormone (PTH), resulting in increased serum calcium levels. The aim of this study was to analyze changing trends in preoperative localization and surgical techniques for the treatment of PHPT in a single tertiary center in Korea. Methods: Data from patients with PHPT who had undergone parathyroidectomy between January 2000 and December 2016 were evaluated in this retrospective analysis. Results: Data from 157 patients were included in this analysis (single adenoma n=156, double adenoma n=1). A total of 134 patients underwent ultrasonography for preoperative localization, 110 of which were marked preoperatively. Preoperative localization by sonographic marking increased over time following its introduction in 2006. Intraoperative PTH assay was used in 80 patients, with its use also increasing each year since it was introduced in 2011. In addition, 150 patients underwent 99mTc-sestamibi scan and 148 underwent computed tomography (CT) scanning. Four-dimensional CT and 99mTc-sestamibi SPECT/CT (SeS) was introduced in 2011 and replaced the use of 2-dimensional CT and 99mTc-sestamibi scan over time. Statistical analysis revealed that sonographic marking, SeS, CT, intraoperative PTH significantly reduce operation time. Surgical techniques used were bilateral neck exploration (n=11), unilateral neck exploration (n=54), focused parathyroidectomy (n=84), and others (n=8). Among 5 surgical technique, focused parathyroidectomy took significantly lesser operation time than other surgical methods. Conclusion: In order to reduce operation time, sonographic marking, SeS, CT, intraoperative PTH should be performed perioperatively, and focused parathyroidectomy could be the first choice of surgical methods.

참고문헌 (28)

참고문헌 신청

Marcocci C / 2011 / Clinical practice. Primary hyperparathyroidism / N Engl J Med 365:2389~2397

Wermers RA / 2006 / Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993–2001 : an update on the changing epidemiology of the disease / J Bone Miner Res 21:171~177

Jong-kyu Kim / 2018 / The prevalence of primary hyperparathyroidism in Korea: a population-based analysis from patient medical records / 대한외과학회지 94(5):235~239

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