Primer Hiperparatiroidide Preoperatif Görüntüleme ve Cerrahi Başarı: 19 Olguluk Retrospektif Analiz Primer Hiperparatiroidide Lokalizasyon ve Cerrahi

Öz

Amaç: Bu çalışmada primer hiperparatiroidi tanısıyla opere edilen hastaların klinik, görüntüleme ve cerrahi sonuçlarının retrospektif olarak değerlendirilmesi ve preoperatif ultrasonografi (USG) ile Tc-99m sestamibi (MIBI) sintigrafisinin lokalizasyon başarısının analiz edilmesi amaçlanmıştır. Gereç ve Yöntem: 2019–2025 yılları arasında İstanbul Aydın Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği’nde primer hiperparatiroidi nedeniyle opere edilen 19 hasta retrospektif olarak incelendi. Sekonder ve tersiyer hiperparatiroidi ile MEN sendromu öyküsü olan hastalar çalışma dışı bırakıldı. Demografik veriler, biyokimyasal parametreler, görüntüleme bulguları, uygulanan cerrahi yöntem ve erken dönem sonuçlar analiz edildi. Bulgular: Hastaların yaş ortalaması 50,4±16,5 yıl olup %73,7’si kadındı. Tüm hastalara USG, 15 hastaya (%78,9) MIBI sintigrafi uygulandı. En az bir görüntüleme yöntemi ile lokalizasyon başarısı %94,7 olarak saptandı. USG ile lokalizasyon oranı %84,2, MIBI ile %93,3 olup yöntemler arasında anlamlı fark izlenmedi (p>0,05). Hastaların %84,2’sine minimal invaziv paratiroidektomi uygulandı. Preoperatif total kalsiyum ve PTH düzeyleri postoperatif 24. saatte anlamlı derecede düştü (p<0,001) ve tüm hastalarda erken dönemde normokalsemi sağlandı. Sonuç: Primer hiperparatiroidide retrospektif verilerimiz, USG ve Tc-99m sestamibi sintigrafisinin yüksek lokalizasyon başarısı sağladığını ve uygun hastalarda minimal invaziv paratiroidektominin güvenle uygulanabildiğini göstermektedir.

Anahtar Kelimeler

• Primer Hiperparatiroidi
• Paratiroid Adenomu
• Ultrasonografi
• Tc-99m Sestamibi
• Minimal İnvaziv Paratiroidektomi

Preoperative Imaging and Surgical Outcomes in Primary Hyperparathyroidism: A Retrospective Analysis of 19 Cases

Öz

Objective: This study aimed to retrospectively evaluate the clinical, imaging, and surgical outcomes of patients operated on for primary hyperparathyroidism and to analyze the localization success of preoperative ultrasonography (USG) and Tc-99m sestamibi (MIBI) scintigraphy. Materials and Methods: Nineteen patients who underwent surgery for primary hyperparathyroidism at the Department of General Surgery, Istanbul Aydın University Faculty of Medicine between 2019 and 2025 were retrospectively reviewed. Patients with secondary or tertiary hyperparathyroidism and those with a history of multiple endocrine neoplasia (MEN) syndrome were excluded. Demographic characteristics, biochemical parameters, imaging findings, surgical approach, and early postoperative outcomes were analyzed. Results: The mean age of the patients was 50.4±16.5 years, and 73.7% were female. All patients underwent USG, and 15 patients (78.9%) underwent MIBI scintigraphy. Localization was achieved in 94.7% of patients with at least one imaging modality. The localization rate was 84.2% with USG and 93.3% with MIBI, with no statistically significant difference between the two modalities (p>0.05). Minimally invasive parathyroidectomy was performed in 84.2% of patients. Preoperative total calcium and PTH levels significantly decreased at postoperative 24 hours (p<0.001), and early normocalcemia was achieved in all patients. Conclusion: Our retrospective data indicate that USG and Tc-99m sestamibi scintigraphy provide high localization success in primary hyperparathyroidism and enable the safe application of minimally invasive parathyroidectomy in appropriately selected patients.

Anahtar Kelimeler

• Primary Hyperparathyroidism
• Parathyroid Adenoma
• Ultrasonography
• Tc-99m Sestamibi
• Minimally Invasive Parathyroidectomy

Kaynakça

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