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Primer hiperparatiroidizmde cerrahi tedavi ve sonuçları

Surgıcal treatment and results of prımary hyperparathyroıdısm

Journal Name:

  • Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2001

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Keywords (Original Language):

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Abstract (2. Language): 
In this study we aimed to evaluate the results of surgical treatment of 11 patients who were treated for primary hyperparathyroidism and followed up in the outpatient clinic of our hospital between 1996-2002. All the patients were women with a mean age of 52.7(between 40-73 years).The mean follow-up time was 9.2 months(between 3-16 months).The mean period of time since onset of symptoms till diagnosis was 22.4 months(between 4-48 months). All the patients had osteodystrophic changes.There were not any asympto¬matic patient in our study group. Preoperative localisation studies included ultrasonography(USG) ,magnetic resonance imaging (MRI) and Tc -sesta MIBI 99m scintigraphy (Sg). One staged initial operation was enough in 9 patients,whereas a second operation was needed in 2 patients. In conclusion, primary hyperparathy-roidism is still an underestimated disease in Turkey and patients are rarely asymptomatic due to delayed diagnosis. According to the western literature however, most of the patients are reported to be asymptomatic. Patients do feel better but they are rarely free of symptoms after surgery. Surgery should be offered even to the asymptomatic patients, because the treatment of possible future complications might be extremely dif¬ficult. Although these outcomes, surgery still remains as the only treatment modality for primary hyper-parathyroidism.
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Abstract (Original Language): 
Bu çalışmada primer hiperparatiroidizm nedeni ile 1996-2002 yılları arasında cerrahi servisimizde ameliyat edilen 11 hastanın tedavi sonuçlarını literatür eşliğinde değerlendirdik. Olguların tamamı kadın olup, ortalama yaş 52.7(40-73 yaş arası değişen şekilde)'idi. Ortalama takip süresi 9.2 aydır (3-16 ay arası değişen şekilde). Semptomların ortaya çıkışı ile tanı arasında geçen süre ortalama 22.4 aydır(4-48 ay arası değişen şekilde). Tüm hastalarda osteodistrofik değişiklikler mevcuttu.Asemptomatik hastamız yoktu. Ameliyat öncesi lokalizasyon çalışmaları arasında ultrasonografi(USG), manyetik rezonans görüntüleme (MRI) ve Tc-sesta MIBI 99m sintigrafisine (Sg) yer verildi.Onbir hastamızın dokuzuna bir cerrahi girişim yeterli olurken,bir hastamızda ameliyat sonrası patolojinin lenf nodülü ile uyumlu gelmesi diğer bir hastamız¬da ise piyesin normal ektopik tiroid dokusu olduğu şeklinde rapor edilmesi üzerine bu iki hastaya mükerrer cerrahi girişim uygulanması gerekmiştir. Sonuç olarak ülkemizde primer hiperparatiroidizm henüz yeterince dikkat çekmeyen bir hastalık olup hastaların tanısı nadiren asemptomatik evrede konabilmektedir. Buna karşın batı kaynaklı literatürlerde opere edilen hastaların büyük çoğunluğu asemptomatiktir. Asemptomatik hastalarda oluşabilecek komplikasyonlarla baş edebilmek güç olduğu için bu tür hastalara dahi cerrahi öner¬ilmelidir. Hastalar ameliyat sonrası kendilerini daha iyi hissetmekle birlikte ,semptomlarından tamamen arın¬maları nadirdir. Tüm bunlara rağmen hiperparatiroidizmde cerrahi vazgeçilmez tedavi modalitesidir.
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  • 4
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  • Turkish

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