TECHNOLOGY AND SCOPE OF OPERATIONS IN PATIENTS WITH PRIMARY AND TERTIARY HYPERPARATHYROIDISM

Purpose: improving outcomes in patients with primary and tertiary hyperparathyroidism by the study of techniques and the volume of intervention in the thyroid and parathyroid glands. Materials and methods. The analysis of treatment of 52 patients with hyperparathyroidism was carried out: 21 patients with primary and 31 patients with tertiary hyperparathyroidism. Among them there were 15 men (28.8%) and 37 women (71.2%). The age of patients ranged from 20 to 80 years. In 71.4% of patients with primary and 77.4% with tertiary hyperparathyroidism the parathyroid gland pathology was combined with pathology of the thyroid gland. In patients with primary hyperparathyroidism, the operation was aimed at the removal of adenomas with high activity and maintenance of unaltered parathyroid glands. In patients with tertiary hyperparathyroidism, it was aimed at total parathyroidectomy. In case of combined pathology in organs, subtotal resection of the thyroid or thyroidectomy was performed. The operation technique is described in detail. Results. In addition to the removal of adenomas in 21 patients with primary hyperparathyroidism, subtotal resection of the thyroid gland was performed in 3 patients, and 12 patients underwent thyroidectomy. Among 31 patients with tertiary hyperparathyroidism, 17 patients had a multi-colloid goiter, which required performing thyroidectomy. Also while searching for parathyroid adenomas, 7 patients required mobilization of the thyroid gland, which was completed by its resection. Conclusion. 55.7% of patients with hyperparathyroidism have a combination of parathyroid and thyroid diseases, which requires implementation of thyroidectomy and removal of adenomas of parathyroid glands. In 19.2% of patients with hyperparathyroidism, the peculiarities of parathyroid adenoma location requires mobilization of the thyroid gland, which causes resection of the thyroid gland and removal of parathyroid adenomas.

primary and tertiary hyperparathyroidism, thyroid disease, technology and volume of operations