Cirugía mínimamente invasiva abierta radioguiada con minigammacámara en el hiperparatiroidismo primario. Estudio evolutivo y análisis crítico de los resultados.

Identificador:  TDX:2628

Handle: https://hdl.handle.net/20.500.11797/TDX2628

Autors:  Pérez-Bermúdez Megía, Carlos Francisco

Resum:
Primary hyperparathyroidism (PPH) is due to excessive secretion of parathyroid hormone (PTH) from the parathyroid glands and its only curative treatment in surgery. HPP is produced in 80-85% of cases by a single adenoma of the 4 parathyroids. Previously it was difficult to locate the adenoma with the imaging tests and the attitude was to surgically localize the 4 parathyroids but with the advancement of science today it can be located preoperatively in most cases the adenoma and perform minimally invasive parathyroidectomy MIP). Objective: To evaluate the results of the IMC with radioguided by minigamacamara in the parathyroid adenoma and to compare with the traditional technique (SP) in the different circumstances. Methodology: 142 patients were operated between June 2006 and February 2014. There were 143 cases because one patient was reoperated. 71 cases were intervened through CMI and 71 via CA, of which there were 21 in which, in addition to performing parathyroidectomies, thyroid surgery was associated. Analytical parameters, pathological findings, cure rates, complication rates and hospital stay between the surgeries performed as well as with the CA performed previously in the service were compared. Results: 96.72% of CMIs were cured, as were 92.5% of SPs. CAs performed previously in the service had a cure rate of 95.77%. Conclusion: he open mini-camera MIP and SP have similar cure rate but open mini-camera MIP has a lower rate of complications and a shorter hospital stay. Its effectiveness is not reduced in the case of ectopic adenomas and its conversion rate is adequate. Therefore, it is the technique of choice in PPH with the suspicion of a single adenoma by preoperative localization tests