Aspects of surgical treatment of primary hyperparathyroidism
Aim. To evaluate the results of surgical treatment of patients with primary hyperparathyroidism. Material and methods. The work is based on retrospective and prospective analysis of the results of treatment among 81 patients with typical clinical manifestations of primary hyperparathyroidism in t...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN UK |
| Publicado: |
Danylo Halytsky Lviv National Medical University
2019
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/a57c6de01c0a4d169b9b73a6e9eae9df |
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| Sumario: | Aim. To evaluate the results of surgical treatment of patients with primary hyperparathyroidism.
Material and methods. The work is based on retrospective and prospective analysis of the results of treatment among 81 patients with typical clinical manifestations of primary hyperparathyroidism in the Ivano-Frankivsk Regional Clinical Hospital from 2014 till 2019. As a result of screening, various forms of primary hyperparathyroidism were diagnosed in 49 (60.4%) patients. The removal of one parathyroid gland was performed in 34 (69.3%) patients; of two glandss - in 12 (24.4%) patients. In 3 (6.1%) patients, there was an atypical placement of parathyroid gland;retrotracheal in two cases: and retrosternal in one.
Results and discussion.Arenal form of primary hyperparathyroidism was diagnosed in 17 (34.6%) patients;an asymptomatic course - in 14 (28.5%) patients;a mixed form - in 11 (22.4%); a bone form - in 6 (14.2%) . In 2 (4%) patients severe transit hypoparathyroidism developed after the operation. In 7 (63.6%) patients with the mixed form of primary hyperparathyroidism, the pain in the bones and joints reduced significantly after the surgery. Among 6 patients with the bone form of primary hyperparathyroidism after parathyroidectomy, in4 (66.6%) patients endoprosthetics of hip joints was performed due to pathological fractures; a successful osteosynthesis of the femur - in 2 (33.3%) patients. Among 11 (78.5%) patients with asymptomatic form of primary hyperparathyroidism, the values of phosphorous-calcium metabolism were normalized after parathyroidectomy. Thus, only in 3 (6.1%) patients, the level of parathyroid hormone exceeded the normin 2 months after the operation.
Conclusions.A diagnosis of primary hyperparathyroidism is an indication for surgical treatment regardless of the form of the disease. Among patients with clinical signs of the disease, in-depth screening allowed diagnosingit in 60.4% of the surveyed. |
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