- SDÜ Tıp Fakültesi Dergisi
- Vol: 30 Issue: 1
- EFFECTS OF PREOPERATIVE FINDINGS ON POSTOPERATIVE RESULTS IN PATIENTS UNDERGOING SURGERY FOR PRIMARY...
EFFECTS OF PREOPERATIVE FINDINGS ON POSTOPERATIVE RESULTS IN PATIENTS UNDERGOING SURGERY FOR PRIMARY HYPERPARATHYROIDISM
Authors : Ismail Hasirci, Çetin Kotan
Pages : 97-105
Doi:10.17343/sdutfd.1229962
View : 9 | Download : 4
Publication Date : 2023-03-14
Article Type : Research
Abstract :Objective To investigate the success of imaging methods and the effect of preoperative findings on postoperative results in patients who underwent surgery for primary hyperparathyroidism (p-HPT). Material and Method In this study, the data of 50 consecutive patients who underwent p-HPT surgery at the General Surgery Clinic of Yuzuncu Yil University Faculty of Medicine between January 2008 and December 2010 were prospectively analyzed. During the study period, the patients’ demographic data, clinical findings, preoperative and postoperative laboratory results, findings of ultrasonography, scintigraphy, and computed tomography performed for localization in the preoperative period, and surgery and pathology reports were evaluated and recorded. The obtained data were statistically analyzed. Results Musculoskeletal pain was the most common (80%) reason for the patients’ presentation to the hospital. In the operated patients, the serum parathormone and calcium levels significantly decreased compared to the preoperative period (p<0.05). The rate of patients who underwent bilateral neck dissection was 30%. In the histopathological examination of the glands, adenoma lesions were detected in 88% of the patients, and the rate of those with a pathology result of parathyroid hyperplasia was 12%. In addition, 4% of the patients had ectopic pathological glands (retroesophageal, anterior mediastinum), and 4% had double adenomas. The sensitivity of ultrasonography in detecting pathological glands was calculated as 72%. However, ultrasonography did not accurately localize all ectopic (4%) and double adenoma (4%) lesions. The postoperative calcium values were similar between the patients that underwent simultaneous thyroidectomy and those that did not undergo this operation, but the parathormone values measured on the second postoperative day were significantly lower in the former. Conclusion Although ultrasonography has a high diagnostic value, it can cause mislocalization in the presence of multiple lesions with atypical localization. The risk of postoperative hypocalcemia increases as surgical exploration increases.Keywords : Endokrin cerrahi, Paratiroid adenomu, Hiperparatiroidi.