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Postoperative recur...
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Hellman, PerUppsala universitet,Endokrinkirurgi
(författare)
Postoperative recurrence and hypoparathyroidism in hyperparathyroidism of multiple endocrine neoplasia type 1
- Artikel/kapitelEngelska1998
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LIBRIS-ID:oai:DiVA.org:uu-63431
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-63431URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Background. Operation and reoperation for hyperparathyroidism in multiple endocrine neoplasia type 1 (MEN 1) is controversial regarding surgical strategy, preoperative localization, and biochemical indexes of recurrence. Methods. Fifty patients with MEN 1 with hyperparathyroidism were followed up 2 to 27 years after subtotal (SPX; n = 35) or total parathyroidectomy with forearm autografiing (TPX; n = 15), including 24 who underwent 28 reoperations because of persistent or recurrent hyperparathyroidism. Results. Persistent or recurrent hyperparathyroidism was seen in 66% and 20% of patients after SPX involving extirpation of at least 3 glands and TPX, respectively, and 100% after single-gland excision as a primary procedure. After reoperation, hypercalcemia was reversed in 33% of patients by SPX and 61% by intended TPX procedures. All patients received vitamin D substitution after TPX, but restricted thyroid function allowed withdrawal in all but 10 patients (36%). Intact serum parathyroid hormone levels in nongrafted and grafted arms rose with time, but only exceptional ratios localized graft recurrence. Localization of recurrent hyperparathyroidism was achieved with 11 C-labeled methionine positron emission tomography. Conclusion. MEN 1 hyperparathyroidism has a high risk of recurrence, and operation may include primarily SPX of at least 3 glands or TPX, although the latter includes a higher risk of long-term hypoparathyroidism. Reoperation should involve TPX with recognition of the enhanced recurrence rate in individuals with postoperative hyperparathyroidism.
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Skogseid, BrittUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)brittsko
(författare)
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Öberg, KjellUppsala universitet,Institutionen för medicinska vetenskaper
(författare)
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Juhlin, ClaesUppsala universitet,Endokrinkirurgi
(författare)
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Åkerström, GöranUppsala universitet,Endokrinkirurgi
(författare)
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Rastad, JonasUppsala universitet,Endokrinkirurgi
(författare)
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Uppsala universitetEndokrinkirurgi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Surgery124:6, s. 993-9990039-60601532-7361
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