Aykut SOYDER, Mustafa ÜNÜBOL, Eyüp YILMAZ, Engin GÜNEY

Before Minimally Invasive Parathyroidectomy in Patients with Primary Hyperparathyroidism Ultrasonography Accompanied by Methylene Blue Staining: A Case Guided Review

Primary hyperparathyroidism is an endocrine disease that leads to the excessive secretion of the parathyroid hormone. In most patients with an underlying disease of parathyroid adenoma, its excision usually provides the definitive treatment. However, localization in surgery can be difficult due to the wide anatomic location of the parathyroid gland caused by changes in the shape and number. Especially parathyroidectomy had neck surgery in a patient poses a problem for endocrine surgeons still important. Determining the localization among these patients is more difficult. Compared to patients who have previously undergone neck surgery, a higher number of recurrent laryngeal nerve injuries and an increased incidence of postoperative hypocalcemia are noted, and a lower number of cure rates exist. In this case, we evaluated preoperative ultrasound-guided parathyroid adenoma lesions detected by the methylene blue stain, making painting easier during the operation and the postoperative treatment successful.

Primer Hiperparatiroidizmli Hastada Minimal İnvaziv Paratiroidektomi Öncesi Ultrasonografi Eşliğinde Metilen Mavisi ile Boyama Yönteminin Bir Olgu Eşliğinde Değerlendirilmesi

Primer hiperparatiroidizm, parathormonun aşırı sekresyonu ile giden endokrin bir hastalıktır. Hastalarının çoğunda altta yatan neden paratiroid adenomdur. Paratirod adenomun cerrahi eksizyonu genellikle kesin tedavisini sağlamaktadır. Paratiroid bezlerinin geniş anatomik konumu, şekil ve sayısındaki değişiklik sebebiyle cerrahide bazı lokalizasyon bulma zorluklarına sebep olabilmektedir. Özellikle boyun cerrahisi geçirmiş bir hastada paratiroidektomi, endokrin cerrah için halen önemli bir sorun oluşturmaktadır. Bu hastalarda lokalizasyonu saptamak daha güçtür. Daha önce boyun cerrahisi geçirmemiş hastalara göre reküren laringeal sinir hasarı ve postoperatif hipokalsemi görülme artışı daha fazla olup, daha düşük kür oranları mevcuttur. Biz bu olguda preoperatif ultrasonografi eşliğinde paratiroid adenom düşünülen lezyona metilen mavisi ile boyama yapıp operasyon sırasında lezyonun kolay tespit edilebilirliğini ve postoperatif tedavi başarısını değerlendirdik.

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