全乳晕腔镜入路外科治疗原发性甲状旁腺功能亢进-东南大学学报医学版

全乳晕腔镜入路外科治疗原发性甲状旁腺功能亢进

单位：首都医科大学附属北京友谊医院普通外科分中心, 国家消化系统疾病临床医学研究中心, 北京 100050

分类号：R616.5;R653

出版年·卷·期（页码）：2022·41·第五期（708-712）

摘要：

目的：探讨原发性甲状旁腺功能亢进通过全乳晕腔镜入路外科手术治疗的安全性及有效性。方法：回顾性分析2018年1月至2020年10月在首都医科大学附属北京友谊医院，接受全乳晕腔镜入路外科手术治疗的7例原发性甲状旁腺功能亢进病人的相关临床及随访资料。术前明确诊断、精准定位。对所有病人术前、术后血清全段甲状旁腺素、血钙情况进行检测。观察术后有无并发症，如声音嘶哑、出血、低钙血症、皮下气肿等。总随访时间为13~46个月，期间观察病人是否出现相关并发症及有无复发等情况。结果：通过全乳晕腔镜入路外科手术，所有病人均未中转开放，并顺利完成。围手术期内，亦无手术相关的严重并发症发生。手术时间80~135 min，平均（102.14±21.77） min。住院时间为4~7 d，平均（5.43±1.13） d。术后有3例病人出现一过性低钙血症表现，给予静脉及口服补钙对症治疗，所有病人均获得痊愈。整个随访期间无复发病例。所有病人对手术美容效果满意。结论：原发性甲状旁腺功能亢进病人在有严格手术适应证的前提下，通过全乳晕腔镜入路外科手术治疗不仅安全、有效，且美容效果更优。

Objective: To investigate the safety and efficacy of breast areola endoscopic surgical approach for primary hyperparathyroidism. Methods: A retrospective analysis in Beijing Friendship Hospital, Capital Medical University was performed on the clinical and follow-up data of 7 patients with primary hyperparathyroidism who received breast areolar endoscopic surgical treatment from January 2018 to October 2020. Preoperative diagnosis and accurate positioning had been done.Preoperative and postoperative serum parathyroid hormone and serum calcium levels were detected in all patients.Postoperative complications such as hoarseness, bleeding, hypocalcemia, subcutaneous emphysema were analyzed. The total follow-up time was 13 to 46 months, during which patients were followed for complications and recurrence. Results: The breast areola endoscopic approach surgery was performed successfully in all patients without conversion. During the perioperative period, no serious complications related to the operation occurred. The operation time was 80-135 min[(102.14±21.77) min]. And the length of stay was 4-7 d[(5.43±1.13) d]. After operation, three patients showed transient hypocalcemia which were treated by intravenous and oral calcium supplement. All patients were cured. It hasn't been detected for recurrent cases during the whole period of follow up. All patients were satisfied with the cosmetic results. Conclusion: Patients with primary hyperparathyroidism which surgical treatment through breast areola endoscopic approach under the premise of strict surgical indications were not only safe and effective, but also had better cosmetic effect.

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