腎性上皮小体機能亢進症の診断と外科治療

概要

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Forty-three patients with chronic renal failure and secondary hyperparathyroidism underwent parathyroid surgery. The first 20 patients were submitted to subtotal parathyroidectomy, and the last 23 patients underwent total parathyroidectomy and parathyroid autotransplantation in the forearm. Non-invasive image diagnosis, CT, ultrasonography and scintigraphy are valuable for 1) making a definite diagnosis of secondary hyperparathyroidism, 2) locating the tumor 3) determining the effectiveness of treatment, and 4) differentially diagnosing thyroid tumors. For surgical treatment, we recommend total parathyroidectomy and autotransplantation in the forearm because the second operation for recurrence may be done more safely and easily than after subtotal parathyroidectomy.