Adénome parathyroïdien : stratégie chirurgicale

作者: D. Malinvaud , G. Potard , C. Martins-Carvalho , J.A. Jézéquel , R. Marianowski

DOI: 10.1016/S0003-438X(06)76683-X

关键词:

摘要: Objectifs Le but de ce travail est d’etudier la prise en charge des adenomes parathyroidiens et discuter l’interet explorations preoperatoires pour adapter au mieux une strategie chirurgicale, ses consequences matiere cout. Materiel methodes Il s’agit d’une etude retrospective 51 patients operes dans notre etablissement entre 1997 2002 le traitement hyperparathyroidie primitive (HPTP). Tous les ont eu exploration preoperatoire localiser ces tumeurs parathyroidiennes, comprenant echographie cervicale cas scintigraphie sestamibi 49 cas. Deux types voies d’abord ete realises, soit un abord unilateral, bilateral. Resultats La realisation d’un bilan systematique a conduit effectuer chirurgie unilaterale chez 76 % (39/51), dont 31 (12/39) sous anesthesia locale. Conclusions haute sensibilite examens adenomas cadre l’HPTP autorise ciblee par voie unilaterale, realisable anesthesie Ils apportent gain considerable, limitant duree l’intervention l’hospitalisation, ainsi que risques complications. permettent reduction du cout global cette nous apparaissent indispensables realiser.

参考文章(29)
R P Burns, W L Russell, W B Brock, L D Graham, S M Roe, Cost-effectiveness of preoperative localization studies in primary hyperparathyroid disease. Annals of Surgery. ,vol. 219, pp. 582- 586 ,(1994)
Hideyuki Wakamatsu, Shiro Noguchi, Hiroyuki Yamashita, Hiroto Yamashita, Shozo Tamura, Seishi Jinnouchi, Shigeki Nagamachi, Shigemi Futami, Technetium-99m tetrofosmin for parathyroid scintigraphy: a direct comparison with 99mTc-MIBI, 201Tl, MRI and US European Journal of Nuclear Medicine and Molecular Imaging. ,vol. 28, pp. 1817- 1827 ,(2001) , 10.1007/S002590100627
Michael M Krausz, Zila Shen-Or, Bishara Bishara, Michal Mekel, Elena Segal, Sofia Ish-Shalom, Adel Abu Salih, Ahmed Mahajna, Michal Barak, Minimally invasive surgery for treatment of hyperparathyroidism. Israel Medical Association Journal. ,vol. 7, pp. 323- 327 ,(2005)
Ashok R. Shaha, Charles A. LaRosa, Bernard M. Jaffe, Parathyroid localization prior to primary exploration American Journal of Surgery. ,vol. 166, pp. 289- 293 ,(1993) , 10.1016/S0002-9610(05)80976-6
Colin F. J. Russell, James D. Laird, W. Rodney Ferguson, Scan-directed unilateral cervical exploration for parathyroid adenoma: A legitimate approach? World Journal of Surgery. ,vol. 14, pp. 406- 408 ,(1990) , 10.1007/BF01658540
Vinay K. Gupta, Karen A. Yeh, George J. Burke, John P. Wei, 99m-Technetium sestamibi localized solitary parathyroid adenoma as an indication for limited unilateral surgical exploration. American Journal of Surgery. ,vol. 176, pp. 409- 412 ,(1998) , 10.1016/S0002-9610(98)00244-X
Keith S. Heller, Joseph N. Attie, Sanford Dubner, Parathyroid localization: inability to predict multiple gland involvement. American Journal of Surgery. ,vol. 166, pp. 357- 359 ,(1993) , 10.1016/S0002-9610(05)80332-0