THE CAUSES AND PREVENTION FOR REOPERATION OF PRIMARY HYPERPARATHYROIDISM_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

赵永恒 ¹ , 赵洪勋 ² , 纪宗正 ³ , 李笃山 ³

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Keywords：

甲状旁腺机能亢进症; 再手术; 预防

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目的总结分析原发性甲状旁腺机能亢进症再手术的原因。
方法对我院1980年至1999年收治的8例原发性甲状旁腺机能亢进症术后因症状持续存在或复发而行再手术的病例，并结合有关文献对其原因进行了总结分析。
结果首次手术失败主要原因： ①多个腺体发生病变(4例)； ②病变腺体异位(5例)； ③医生经验不足(5例)； ④冰冻切片诊断错误(2例)； ⑤残留腺体增生(1例)； ⑥存在第5个或以上甲状旁腺腺瘤； ⑦甲状旁腺癌复发。
结论结合术前定位检查，并熟悉掌握甲状旁腺病变正常和异常的位置，可以提高原发性甲状旁腺机能亢进症首次探查术的成功率。

Citation： 赵永恒,赵洪勋,纪宗正,李笃山. THE CAUSES AND PREVENTION FOR REOPERATION OF PRIMARY HYPERPARATHYROIDISM. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2000, 7(6): 397-398. doi: Copy

1.	Clark OH, Duh QY. Primary hyperparathyroidism, a surgical perspective 〔Ｊ〕. Endocrinol Metab Clin North Am, 1998; 18(3)∶701.
2.	Levin KE, Clark OH. The reasons for failure in parathyroid operations 〔Ｊ〕. Arch Surg, 1989; 124(8)∶911.
3.	Cheung PSY, Borgstrom A. Strategy in reoperative surgery for hyperparathyroidism 〔Ｊ〕. Arch Surg, 1989; 124(6)∶676.
4.	Wang CA. Parathyroid reexploreation: a clinical and pathological study of 112 cases 〔Ｊ〕. Ann Surg, 1977; 186(2)∶140.
5.	Levin KE, Gooding GAW, Okerlnd MD, et al. Localizing studies in patients with persistent or recurrent hyperparathyroidism 〔Ｊ〕. Surgery, 1987; 102(6)∶917.
6.	Clark OH, Norma D. Localization studies in patients with persistent or recurrent hyperparathyroidism 〔Ｊ〕. Surgery, 1985; 98(6)∶1083.
7.	Roe SM, Burns RP. Costeffectiveness of preoperation localization studies in primary hyperparathyroidism 〔Ｊ〕. Ann Surg, 1994; 219(5)∶582.
8.	Mariette C, Pellissier L, Combemale F, et al. Reoperation for persistent or recurrent primary hyperparathyroidism 〔Ｊ〕. Langenbecks Arch Surg, 1998; 383(2)∶174.
9.	James C, Starks M, MacGillivaray DC, et al. The imaging studies in the diagnosis and management of thyroid cancer and hyperthyroidism 〔Ｊ〕. Surg Oncol Clin N Am, 1999; 8(1)∶145.
10.	Wang CA. The anatomic basis of parathyroid surgery 〔Ｊ〕. Am Surg, 1976; 183(3)∶271.
11.	刘自宽，王鹏志，齐骏等. 原发性甲状旁腺机能亢进症的临床实践〔Ｊ〕. 天津医药， 1987； 15(8)∶474.
12.	Salti GI, Fedorak I. Continuing evoluation in the operative management of primary hyperparathyroidism 〔Ｊ〕. Arch Surg, 1992; 127(8)∶831.
13.	Thompson NW, Eckhauser FE. The anatomy of primary hyperparathyroidism 〔Ｊ〕. Surgery, 1982; 5(92)∶814.

1. Clark OH, Duh QY. Primary hyperparathyroidism, a surgical perspective 〔Ｊ〕. Endocrinol Metab Clin North Am, 1998; 18(3)∶701.
2. Levin KE, Clark OH. The reasons for failure in parathyroid operations 〔Ｊ〕. Arch Surg, 1989; 124(8)∶911.
3. Cheung PSY, Borgstrom A. Strategy in reoperative surgery for hyperparathyroidism 〔Ｊ〕. Arch Surg, 1989; 124(6)∶676.
4. Wang CA. Parathyroid reexploreation: a clinical and pathological study of 112 cases 〔Ｊ〕. Ann Surg, 1977; 186(2)∶140.
5. Levin KE, Gooding GAW, Okerlnd MD, et al. Localizing studies in patients with persistent or recurrent hyperparathyroidism 〔Ｊ〕. Surgery, 1987; 102(6)∶917.
6. Clark OH, Norma D. Localization studies in patients with persistent or recurrent hyperparathyroidism 〔Ｊ〕. Surgery, 1985; 98(6)∶1083.
7. Roe SM, Burns RP. Costeffectiveness of preoperation localization studies in primary hyperparathyroidism 〔Ｊ〕. Ann Surg, 1994; 219(5)∶582.
8. Mariette C, Pellissier L, Combemale F, et al. Reoperation for persistent or recurrent primary hyperparathyroidism 〔Ｊ〕. Langenbecks Arch Surg, 1998; 383(2)∶174.
9. James C, Starks M, MacGillivaray DC, et al. The imaging studies in the diagnosis and management of thyroid cancer and hyperthyroidism 〔Ｊ〕. Surg Oncol Clin N Am, 1999; 8(1)∶145.
10. Wang CA. The anatomic basis of parathyroid surgery 〔Ｊ〕. Am Surg, 1976; 183(3)∶271.
11. 刘自宽，王鹏志，齐骏等. 原发性甲状旁腺机能亢进症的临床实践〔Ｊ〕. 天津医药， 1987； 15(8)∶474.
12. Salti GI, Fedorak I. Continuing evoluation in the operative management of primary hyperparathyroidism 〔Ｊ〕. Arch Surg, 1992; 127(8)∶831.
13. Thompson NW, Eckhauser FE. The anatomy of primary hyperparathyroidism 〔Ｊ〕. Surgery, 1982; 5(92)∶814.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

THE CAUSES AND PREVENTION FOR REOPERATION OF PRIMARY HYPERPARATHYROIDISM

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