Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)

Parathyroidectomy is the leading treatment for drug-refractory secondary and tertiary hyperparathyroidism in patients with chronic kidney disease. Difficulties in performing this surgery are mainly associated with the anatomical features of the parathyroid glands, in particular with the variability...

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Autores principales:	E. A. Ilyicheva, D. A. Bulgatov, A. V. Zharkaya, V. N. Makhutov, E. G. Grigoryev
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2020
Materias:	ectopic parathyroid gland secondary hyperparathyroidism anterior mediastinum parathyroidectomy Science Q
Acceso en línea:	https://doaj.org/article/38bf8df81d9e41fe972324d2501b97eb
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spelling	oai:doaj.org-article:38bf8df81d9e41fe972324d2501b97eb2021-11-23T06:14:44ZSurgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)2541-94202587-959610.29413/ABS.2020-5.4.12https://doaj.org/article/38bf8df81d9e41fe972324d2501b97eb2020-09-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/2397https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596Parathyroidectomy is the leading treatment for drug-refractory secondary and tertiary hyperparathyroidism in patients with chronic kidney disease. Difficulties in performing this surgery are mainly associated with the anatomical features of the parathyroid glands, in particular with the variability of their number and topographic anatomy. Ectopic parathyroid glands are one of the most common causes of persistence or recurrence of secondary hyperparathyroidism after surgery. One of the common variants of ectopia is the localization of the parathyroid gland in the anterior-superior mediastinum. The article discusses the features of surgical treatment of secondary hyperparathyroidism in patients with end-stage chronic kidney disease with this ectopia. A new method of treating hyperparathyroidism in patients with an atypical location of the parathyroid gland in the anterior-superior mediastinum is presented. This method is characterized by low invasiveness of access, ease of implementation without using special equipment and instruments. The proposed method was used in the treatment of a patient with secondary hyperparathyroidism due to chronic renal failure as a result of chronic glomerulonephritis. The duration of hemodialysis at the time of the surgery was more than 17 years. In the presented clinical case, ectopia of one of the pathologically altered parathyroid glands in the anterior-superior mediastinum was found at the preoperative stage. As a method of surgical treatment, we carried out total parathyroidectomy with autotransplantation of a fragment of parathyroid tissue into the brachioradialis muscle. Thanks to this method, it was possible to remove the atypically located parathyroid gland from the cervicotomy access and to discharge the patient within the standard terms for a given volume of surgery.E. A. IlyichevaD. A. BulgatovA. V. ZharkayaV. N. MakhutovE. G. GrigoryevScientific Сentre for Family Health and Human Reproduction Problemsarticleectopic parathyroid glandsecondary hyperparathyroidismanterior mediastinumparathyroidectomyScienceQRUActa Biomedica Scientifica, Vol 5, Iss 4, Pp 84-89 (2020)
institution	DOAJ
collection	DOAJ
language	RU
topic	ectopic parathyroid gland secondary hyperparathyroidism anterior mediastinum parathyroidectomy Science Q
spellingShingle	ectopic parathyroid gland secondary hyperparathyroidism anterior mediastinum parathyroidectomy Science Q E. A. Ilyicheva D. A. Bulgatov A. V. Zharkaya V. N. Makhutov E. G. Grigoryev Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)
description	Parathyroidectomy is the leading treatment for drug-refractory secondary and tertiary hyperparathyroidism in patients with chronic kidney disease. Difficulties in performing this surgery are mainly associated with the anatomical features of the parathyroid glands, in particular with the variability of their number and topographic anatomy. Ectopic parathyroid glands are one of the most common causes of persistence or recurrence of secondary hyperparathyroidism after surgery. One of the common variants of ectopia is the localization of the parathyroid gland in the anterior-superior mediastinum. The article discusses the features of surgical treatment of secondary hyperparathyroidism in patients with end-stage chronic kidney disease with this ectopia. A new method of treating hyperparathyroidism in patients with an atypical location of the parathyroid gland in the anterior-superior mediastinum is presented. This method is characterized by low invasiveness of access, ease of implementation without using special equipment and instruments. The proposed method was used in the treatment of a patient with secondary hyperparathyroidism due to chronic renal failure as a result of chronic glomerulonephritis. The duration of hemodialysis at the time of the surgery was more than 17 years. In the presented clinical case, ectopia of one of the pathologically altered parathyroid glands in the anterior-superior mediastinum was found at the preoperative stage. As a method of surgical treatment, we carried out total parathyroidectomy with autotransplantation of a fragment of parathyroid tissue into the brachioradialis muscle. Thanks to this method, it was possible to remove the atypically located parathyroid gland from the cervicotomy access and to discharge the patient within the standard terms for a given volume of surgery.
format	article
author	E. A. Ilyicheva D. A. Bulgatov A. V. Zharkaya V. N. Makhutov E. G. Grigoryev
author_facet	E. A. Ilyicheva D. A. Bulgatov A. V. Zharkaya V. N. Makhutov E. G. Grigoryev
author_sort	E. A. Ilyicheva
title	Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)
title_short	Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)
title_full	Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)
title_fullStr	Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)
title_full_unstemmed	Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)
title_sort	surgical treatment of secondary hyperparathyroidism at ectopic parathyroid gland in anterior-superior mediastinum (literature review and clinical case)
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2020
url	https://doaj.org/article/38bf8df81d9e41fe972324d2501b97eb
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Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)

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