술중 부갑상선 호르몬 측정을 이용하여 제거한다발성 부갑상선 증식증 1예
A Case of Minimally Invasive Parathyroidectomy Using IntraoperativeiPTH Monitoring to Ensure Operative Success
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Abstract
The frequency of hyperparathyroidism has slowly increased recently with routine measurement of serum calcium and increasingawareness by the public of the disease.1) The success of parathyroid surgery depends on the identification and removal of all hyperactiveparathyroid tissue.2) Advances in preoperative imaging, such as high resolution ultrasonography and Tc-99m sestamibi,plays a major role in the targeted operative approach that does not disturb the normal parathyroid glands.3) Tc 99m sestamibiscanning is generally viewed as the gold standard for preoperative parathyroid localization with high sensitivity and specificity,3)while the intraoperative measurement of intact parathyroid hormone (iPTH) provides the surgeon with a quantitative test thatpredicts the postoperative serum calcium level and can justify early closure or further exploration for hyperfunctioning parathyroidgland.4) Therefore, the combination of Tc-99m sestamibi and rapid intraoperative iPTH measurement enable minimally invasivetechniques for multiple parathyroid lesions.2) The combination of Tc-99m sestamibi and intraoperative iPTH monitoring, indispensablefor securing operative success, represents an accurate and effective diagnostic tools.2) The authors experienced acase that proved the combination of Tc-99m sestamibi and rapid intraoperative PTH monitoring useful and made a report with areview of literature. (Korean J Otolaryngol 2006;49:852-6)
참고문헌 (18)
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