Reoperationen bei persistierendem oder rezidivierendem Hyperparathyreoidismus

Rothmund, M.; Wagner, Maria; Pluntke, K.

doi:10.1007/s001040050872

Cited by 12 publications

(18 citation statements)

References 17 publications

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“…Additionally, we routinely performed ultrasonography of the neck and forearm after clinical examination. Further diagnostic procedures were suggested to detect recurrent or persistent HPT: intact PTH gradient, ultrasonography, Tc-labeled sesta-MIBI scan, magnetic resonance imaging or computed tomography [27,28]. Surgery is indicated if two of this procedures show the same localization.…”

Section: Less Recurrent Hyperparathyroidism After Total Parathyroidecmentioning

confidence: 99%

Total parathyroidectomy without autotransplantation as a standard procedure in the treatment of secondary hyperparathyroidism

Ockert

Willeke

Richter

et al. 2002

Langenbeck's Archives of Surgery

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Section: Less Recurrent Hyperparathyroidism After Total Parathyroidecmentioning

confidence: 99%

Total parathyroidectomy without autotransplantation as a standard procedure in the treatment of secondary hyperparathyroidism

Ockert

Willeke

Richter

et al. 2002

Langenbeck's Archives of Surgery

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“…Some authors recommend mediastinal exploration and thymectomy to resect additional parathyroid glands and to avoid recurrence caused by cervical spilling. 27 In our patients, however, we found 4 supernumerary glands; 2 of them were located in the thymus tongue, and thymectomy from the neck incision was performed. Two intrathyroidal supernumerary glands could be removed based on preoperative identification by US diagnosis.…”

Section: Discussionmentioning

confidence: 59%

Total parathyroidectomy with autotransplantation in patients with renal hyperparathyroidism: indications and surgical approach

Gourgiotis¹,

Moustafellos²,

Stratopoulos³

et al. 2006

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ObJEctIVE: renal hyperparathyroidism (rH) is one of the most serious complications in long-term hemodialysis patients. the purpose of this retrospective study was the evaluation of the surgical indications, parathyroid histology, and the results of total parathyroidectomy with autotransplantation (Ptx+At) in patients with rH. DEsIGN: the study included 36 patients with rH in whom Ptx+At was carried out at the First surgical Department of the Evangelismos Hospital over a 5-year period. Indications for Ptx+At were high levels of parathyroid hormone (PtH >800 ng/L) associated with hypercalcemia and/or hyperphosphatemia, that were refractory to medical treatment, as well as clinical effects of rH, including pruritus, bone and joints pain, muscle weakness, progression of soft tissue calcification, and spontaneous fractures. Ultrasonography, 99m tc sestamibi scan and computed tomography were used to evaluate the thyroid and parathyroids. rEsULts: there was no mortality related to surgery. Preoperative symptoms, serum PtH, serum alkaline phosphatace, hyperphosphatemia, and hypercalcemia were improved or normalised in most patients. recurrence was observed in one case; this autotransplanted patient required resection of transplanted tissue from his forearm. Hypoparathyroidism was not recorded. cONcLUsIONs: Ptx+At is a safe option for the treatment of rH that is accompanied by low morbidity, mortality, and recurrence rate. It is important to identify all parathyroid glands at surgery and to choose adequate parathyroid tissue for autograft.

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“…Hier sollte der Reeingriff frühestens 2 Wochen später nach erneuter Lokalisationsdiagnostik vorgenommen werden. In der Zwischenzeit ist häufig eine medikamentöse Behandlung der Hyperkalzämie erforderlich, die sich nach der Höhe des Serumkalziums richtet [28,29].…”

Section: Zeitpunkt Der Reoperationunclassified

“…Diese Eingriffe und ihre Vorbereitung sollten deshalb nur an Kliniken mit einer dokumentierten Expertise durchgeführt werden [28,29].…”

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Reoperationen beim prim�ren Hyperparathyreoidismus

Karakas

Zielke

Dietz

et al. 2005

Chirurg

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While the initial treatment for primary hyperparathyroidism (pHPT), if managed by an experienced surgeon, is almost always successful, reoperations are challenging. Patients are at high risk for complications and the rates of success are plainly below those of primary cervical explorations. In this paper the reasons for failure during initial procedures are reviewed, as are the most important localization procedures and the prerequisites with regard to technical infrastructure as well as personnel, when planning repeat operations for a missed parathyroid adenoma. Provided that a standardized diagnostic and surgical approach is used, the surgeon is experienced, and up-to-date technical equipment is available, permanent normocalcemia following reoperations in pHPT is more frequently achieved than it used to be. The best option to avoid reoperations and associated complications is a successful initial intervention by an experienced surgeon. However, reoperations should always be performed by an experienced surgeon.

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Reoperationen bei persistierendem oder rezidivierendem Hyperparathyreoidismus

Cited by 12 publications

References 17 publications

Total parathyroidectomy without autotransplantation as a standard procedure in the treatment of secondary hyperparathyroidism

Total parathyroidectomy without autotransplantation as a standard procedure in the treatment of secondary hyperparathyroidism

Total parathyroidectomy with autotransplantation in patients with renal hyperparathyroidism: indications and surgical approach

Reoperationen beim prim�ren Hyperparathyreoidismus

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