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CLINICAL AND PARACLINICAL CHARACTERISTICS AND RESULTS OF SURGERY OF ADENOMA PARATHYROID
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Abstract
Objective:To study the clinical and paraclinical characteristics, evaluate the results of surgery of adenoma parathyroid. Methods: Case series. Materials: 15 patients were diagnosed and operated on for adenoma parathyroid at Hanoi Medical University Hospital. Results: Female / male ratio = 1,14/1, average age is 52 ± 11.21. The main reason for medical examination is periodic health examination. Common symptoms are fatigue (10/15 patients), manifestations of bone and kidneywith high rate, including bone pain (7/15 patients), low back pain (2/15 patients), and other non-specific symptoms such as anorexia, thirst and insomnia. 9/15 of patients have history of urinary stones. The mean concentration of PTH is31.69 ± 16.39 pmol/l, total calciemiaconcentration is 3,05 ± 0,43 mmol/l and ionized calciemia concentration is 1,62 ± 0,22 mmol/l. 10/15 patients were detected tumors by ultrasound. Scintigraphy detected 7/11 patients. CT was conducted in 1 patient and a parathyroid tumor was found. MRI performed in a patient but the result was negative. Selective venous sampling tests for PTH in 3 patients were performed and helped to identify tumors. All 15 patients underwent minimally invasive parathyroidectomy. Each patient had a tumor, mainly in the inferior parathyroid gland. Intraoperative PTH concentrationdecreased more than 50% with a averagedrop 86,04 ±5,52% . The average operative time was 61,33 ± 8,12 minute. Common tumor size were 1-2 cm. No patient had complications during or after surgery. Follow-up after 6 months,all patients hasionized calciemia concentration, total calciemia concentration, PTH within normal ranges. Conclusion: The research showed that clinical symptoms of adenoma parathyroid were non-specific and in many different organs. Diagnosis primary hyperparathyroidism is base on an increase in calcium and parathyroid hormone levels. The 99m-Tc-Sestamibi scintigraphy and ultrasound have high sensitivity. When non-invasive imaging methods arenegative, selective venous sampling is performed. Especially minimally invasive parathyroidectomy has a high success rate, short operative time, and few complications.
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Keywords
Primary hyperparathyroidism, adenoma parathyroid
References
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