One-gland exploration for mediastinal parathyroid adenomas: cervical and thoracoscopic approaches
| Autor: | John A. Ryan, Mark E. Hill, Rockson C. Liu |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adenoma
Male Technetium Tc 99m Sestamibi medicine.medical_specialty endocrine system diseases Parathyroid hormone medicine Thoracoscopy Humans Radionuclide Imaging Aged Retrospective Studies Parathyroid adenoma Parathyroidectomy Hyperparathyroidism medicine.diagnostic_test business.industry Mediastinum General Medicine Middle Aged medicine.disease Surgery Parathyroid Neoplasms Treatment Outcome medicine.anatomical_structure Female Radiopharmaceuticals business Primary hyperparathyroidism Persistent hyperparathyroidism |
| Zdroj: | The American Journal of Surgery. 189:601-605 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2005.01.019 |
| Popis: | Background In patients with sporadic primary hyperparathyroidism, preoperative localization studies may discover a solitary mediastinal parathyroid adenoma. In this circumstance a 1-gland mediastinal exploration, either cervical or thoracoscopic, may be curative. Methods In an 18-month period, 5 of 120 consecutive patients underwent an initial 1-gland mediastinal exploration for a solitary mediastinal parathyroid adenoma and 2 patients had a 1-gland mediastinal exploration for persistent hyperparathyroidism. Clinical presentation, imaging studies, surgical techniques, and outcomes were reviewed. Results Sestamibi scans showed a mediastinal parathyroid adenoma in all 7 patients. Computed tomography provided anatomic localization of middle mediastinal parathyroid adenomas. A cervical approach was used in 4 patients who had a superior mediastinal parathyroid adenoma. Thoracoscopic excision was performed in 3 patients with a middle mediastinal parathyroid adenoma. No complications occurred. Calcium and parathyroid hormone levels normalized in all patients. Conclusions Sporadic primary hyperparathyroidism caused by a solitary mediastinal parathyroid adenoma can be treated successfully with 1-gland mediastinal exploration either by a cervical or a thoracoscopic approach as indicated by localization imaging. |
| Databáze: | OpenAIRE |
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