Tratamento cirúrgico do hiperparatiroidismo primário com pthi intra-operatória

• Autor(a) principal: Allen , Miguel
• Data de Publicação: 2008
• Outros Autores: Almeida, Isabel, Torrinha, Joaquim
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10362/21902
• topic: FOCUSED LATERAL APPROACH; SESTAMIBI; ADENOMA; MINIMALLY INVASIVE PARATHYROIDECTOMY; HORMONE ASSAY; 2 PREOPERATIVE LOCALIZATION; NECK EXPLORATION; REASSESSMENT; EXPERIENCE; SURGERY

INTRODUCTION Primary hyperparathyroidism (pHPT) is most frequently caused by a solitary adenoma. Surgical intervention has a high cure rate, particularly when associated with a fast intraoperative intact parathyroid hormone (IOPTH) assay. Aim: to evaluate the performance and accuracy when applying this technique. METHODS we conducted a retrospective study of the last 20 patients with pHPT (mean age 59, range 24-75) that had a surgical intervention in our unit. IOPTH was used in 14 patients, with dosage at 5, 10, 15 and 30 minutes after removal of the adenoma. RESULTS The localization exams had a sensitivity of >75%. The surgical procedure of choice was a unilateral dissection through a 4cm central mini-incision, with all patients experiencing a reduction of >50% of the IOPTH at 10 minutes. There were no surgical complications and the average length of the follow-up period was 11.4 months. The mean calcemia and iPTH dosage progression, from pre-surgery to the last follow-up visit, was respectively of 11 (SD1) to 9.4 (SD0.5) mg/dl and of 233.3 (SD177.5) to 57.1 (SD42) pg/ml. Symptoms improved in all patients.