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頁籤選單縮合
題名 | Preoperative Localization Procedures for Initial Surgery in Primary Hyperparathyroidism=原發性副甲狀腺機能亢進初次手術的術前定位檢查 |
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作者 | 黃實宏; 賴逸儒; 廖廣義; 鄭雲潔; 蕭永廉; 張天鈞; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 97:10 1998.10[民87.10] |
頁次 | 頁679-683 |
分類號 | 416.214 |
關鍵詞 | 原發性副甲狀腺機能亢進; 手術前定位檢查; Primary hyperparathyroidism; Initial surgical exploration; Noninvasive localization; |
語文 | 英文(English) |
英文摘要 | The experience of the surgeon and precise localization of abnormal parathyroid glands determine the success of surgery for primary hyperparathyroidism (HPT). In HPT patients undergoing repeat surgery, the use of localization studies improved the ability to identify the remaining abnormal parathyroid tissue. This study investigated the roles of preoperative localization techniques for initial surgery for primary HPT. From 1985 through 1997, two noninvasive localization procedures, ultrasonography (US) and thallium chloride-�K �� technetium pertechnetate subtraction scanning (T1-Tc), were used prior to initial exploration for primary HPT in 76 patients. Their accuracy was determined on the basis of surgical and pathologic result. The surgical success rate was 96% (73/76). The sensitivities of US and T1-Tc were 71% and 49%, respectively. The sensitivity of T1-Tc was higher for the lower parathyroid glands. In 21 of 26 patients who underwent fine-needle aspiration (FNA) of the suspected enlarged parathyroid gland, the diagnosis of parathyroid adenoma was confirmed preoperatively. We conclude that the concomitant use of US and FNA is a safe and convenient method for preoperative localization of the parathyroid glands prior to initial surgical exploration in patients with primary HPT. Bilateral neck exploration by an experienced surgeon should be the routine procedure. Us and T1-Tc alone offer limited localization information, and unilateral exploration should be reserved for selected cases in which the results of these two imaging studies are consistent with one another. |
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