Partial Sternotomy Application in Mediastinal Parathyroid Adenomas

Öz

Background: Solitary parathyroid adenomas are the most common cause of primary hyperparathyroidism. Generally neck exploration is adequate for parathyroid adenoma surgery, however some of them aren’t accessible using a cervical approach and sternotomy or thoracotomy can be required. In this study we present surgical application of eight cases with mediastinal parathyroid adenoma.

Material and Methods: Between Jan 2006 - Mar 2018, eight patients who underwent partial sternotomy for mediastinal parathyroid adenoma in our clinic were included in the study. Patients' datas were retrospectively reviewed. Blood tests, radiographic and scintigraphic methods were performed and the results were reviewed. Localization of mediastinal parathyroid adenoma, performed treatment methods and prognosis were evaluated.

Results:  Seven of the cases were female (87.5%) and the mean age was found to be 49.7 years (range: 30-64 years). Bone pain what’s the most common symptom. All of the patients experienced hypercalcemia and hyperparathyroidia. PTH and Ca values returned to normal in postoperative period. No recurrent or consistent hyperparathyroidism was seen during follow-up period. No postsurgical morbidity or mortality developed.

Conclusion: We claimed that partial sternotomy is a safe and adequate method for removing ectopic mediastinal parathyroid adenomas.

Anahtar Kelimeler

• Mediastinal Parathyroid Adenomas,surgery,Partial Sternotomy

Mediastinal Paratiroid Adenomlarında Parsiyel Sternotomi Uygulaması

Öz

Amaç: Primer hiperparatiroidinin en sık nedeni soliter paratiroid adenomlarıdır. Genellikle boyun cerrahisi paratiroid adenomun çıkarılması için yeterlidir, ancak bazılarının servikal bir yaklaşımla ulaşılması mümkün değildir ve sternotomi veya torakotomi gerekebilir. Bu çalışmada mediastinal paratiroid adenomlu sekiz olgunun cerrahi uygulamasını sunduk.

Gereç ve Yöntemler: Ocak 2006- Mart 2018 tarihleri arasında kliniğimizde mediastinal paratiroid adenomu nedeniyle parsiyel sternotomi uygulanan sekiz hasta çalışmaya alındı. Hastaların verileri retrospektif olarak incelendi. Çalışılan kan testleri, radyografik ve sintigrafik yöntemler ve sonuçlar gözden geçirildi. Mediastinal paratiroid adenomunun lokalizasyonu, uygulanan tedavi yöntemleri ve prognozları değerlendirildi.

Bulgular: Olguların 7'si kadın (% 87.5) ve yaş ortalaması 49.7 (30-64) idi. Kemik ağrısı en sık görülen semptomdu. Tüm hastalarda hiperkalsemi ve hiperparatiroidi vardı. Postoperatif dönemde Parathormon (PTH) ve Ca değerleri normale döndü. Takip süresince tekrarlayan veya kalıcı hiperparatiroidizm görülmedi. Cerrahi sonrası morbidite veya mortalite gelişmedi.

Sonuç: Parsiyel sternotomi ektopik mediastinal paratiroid adenomlarını gidermek için güvenli ve yeterli bir yöntem olduğunu düşünmekteyiz.

Anahtar Kelimeler: Mediastinal Paratiroid Adenom, Cerrahi, Parsiyel Sternotomi

Anahtar Kelimeler

• Mediastinal Paratiroid Adenom,Cerrahi,Parsiyel Sternotomi

Kaynakça

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