Analysis of the successful clinical treatment of 140 patients with parathyroid adenoma:A retrospective study  

作　　者：Zhen-Xing Peng Yong Qin Juan Bai Jin-Shu Yin Bo-Jun Wei 

机构地区：[1]Department of Otorhinolaryngology Head and Neck Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China [2]Department of Otorhinolaryngology and Head and Neck Surgery,Peking University First Hospital,Beijing 100034,China [3]Department of Thyroid and Neck Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China

出　　处：《World Journal of Clinical Cases》2022年第28期10031-10041,共11页世界临床病例杂志

摘　　要：BACKGROUND Parathyroid adenoma(PA) sometimes recurs after surgery,how to improve the surgical success rate of PA is the key to the treatment of this disease.AIM To investigate the clinical features,diagnosis,and surgical treatment of patients with PA.METHODS Patients who were pathologically confirmed with PA and had undergone surgery for the first time between January 2010 and December 2017 at the Beijing Shijitan Hospital affiliated to Capital Medical University were included in the study.The clinical features,localization diagnosis,and surgical treatment of these patients were analyzed.RESULTS Of the 140 patients,32 were male and 108 were female;132 cases had one adenoma,and 8 had two adenomas.In addition,114 cases had clinical symptoms,among which 51,28,23,8,and 4 had urinary system,skeletal system,digestive system,neuromuscular system,and neuropsychiatric symptoms,respectively,while 26 cases had no obvious symptoms.The median level of preoperative parathyroid hormone(PTH) was 201.0 pg/m L.The positive detection rate of technetium-99m sestamibi(Tc-99m MIBI) single-photon emission computed tomography/computed tomography(SPECT/CT),ultrasound examination,and the combined use of Tc-99m MIBI SPECT/CT and ultrasound examination was 92.9%,85.5%,and 96.4%,respectively.Open surgery was performed in all patients,and PTH was monitored during surgery.The success rate of surgery was 98.6%.After surgery,21 cases developed hypocalcemia,1 case developed temporary hoarseness,and 19 cases had transient hypoparathyroidism but there was no permanent hypoparathyroidism,postoperative hemorrhage,or hematoma in the surgical area.CONCLUSION For patients with clinically unexplained skeletal system,urinary system,and neuropsychiatric symptoms,the possibility of PA should be considered.Imaging examinations such as ultrasound and Tc-99m MIBI SPECT/CT could be integrated before surgery to obtain accurate localization diagnosis.Precise preoperative localization,intraoperative PTH monitoring,and delicate surgery to protect the integrity of t

关 键 词：Primary hyperparathyroidism Parathyroid adenoma Technetium-99m sestamibi SPECT/CT Surgical treatment Localization diagnosis Intraoperative parathyroid hormone monitoring 

分 类 号：R736.2[医药卫生—肿瘤]