P. Thomopoulos (Professeur des Universités, Praticien hospitalier)
{"title":"Nouveautés thérapeutiques dans l'hyperparathyroïdie primitive","authors":"P. Thomopoulos (Professeur des Universités, Praticien hospitalier)","doi":"10.1016/j.emcend.2005.06.001","DOIUrl":null,"url":null,"abstract":"<div><p>Modern imaging techniques such as ultrasonography and sestamibi scintigraphy (alone or combined with computed-tomography scanning) are useful for the preoperative localisation of a single adenoma in most cases. In such patients, minimally invasive parathyroidectomy may be considered, either by unilateral approach and local anaesthesia or by a video-assisted procedure. The success rate, assessed by perioperative rapid PTH assays, is of 84-90%, reaching 97% after conversion to conventional parathyroidectomy. Thoracoscopic resection may be considered for mediastinal adenomas. Specialized surgical teams have developed hypnotic approaches, locoregional anaesthesia or ultrasound-guided percutaneous ethanol injection. Medical treatment should soon include those calcimimetic drugs that are currently under evaluation. Anti-PTH immunization has shown efficacy in managing the rare cases of parathyroid cancer.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 3","pages":"Pages 129-139"},"PeriodicalIF":0.0000,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.06.001","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"EMC - Endocrinologie","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1762565305000080","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 4
Abstract
Modern imaging techniques such as ultrasonography and sestamibi scintigraphy (alone or combined with computed-tomography scanning) are useful for the preoperative localisation of a single adenoma in most cases. In such patients, minimally invasive parathyroidectomy may be considered, either by unilateral approach and local anaesthesia or by a video-assisted procedure. The success rate, assessed by perioperative rapid PTH assays, is of 84-90%, reaching 97% after conversion to conventional parathyroidectomy. Thoracoscopic resection may be considered for mediastinal adenomas. Specialized surgical teams have developed hypnotic approaches, locoregional anaesthesia or ultrasound-guided percutaneous ethanol injection. Medical treatment should soon include those calcimimetic drugs that are currently under evaluation. Anti-PTH immunization has shown efficacy in managing the rare cases of parathyroid cancer.
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