Current Indications for Surgical Treatment of Primary Hyperparathyroidism in the Elderly

Andrea Polistena,Roberta Lucchini,Massimo Monacelli,Roberta Triola,Stefano Avenia, Ivan Barillaro, Louis Banka Johnson,Alessandro Sanguinetti, Nicola Avenia

Endocrine Abstracts（2018）

Univ Perugia | Lund Univ

Cited 6|Views30

Abstract

This study presents the results of surgery in the elderly for primary hyperparathyroidism (PHPT) from a single institution's experience. We retrospectively analyzed 898 cases of surgically treated PHPT, divided into two groups: 135 elderly patients (A) and 763 patients younger than 65 years (B). PHPT was symptomatic in 68.8 per cent patients in group A and in 81.6 per cent in group B. Unilateral temporary recurrent laryngeal nerve palsy was observed in 0.9 per cent in group A and 0.1 per cent in group B (P > 0.05). No cervical hematomas, mortality or major cardiovascular, neurological, respiratory or metabolic postoperative complications were registered. All the patients evaluated at one year had improvement in the quality of life, with increase of bone mineral density (BMD) in 85.6 per cent and 79.8 per cent of patients in groups A and B, with no significant differences between symptomatic and asymptomatic patients. Parathyroidectomy in elderly PHPT patients is safe, with rate of morbidity similar to what observed in younger individuals. Further investigations are recommended to confirm the role of surgery as an effective approach in elderly PHPT patients.

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primary hyperparathyroidism

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【要点】：本研究展示了单个医疗机构对老年原发性甲旁亢（PHPT）患者手术治疗的结果，创新点在于证明了老年人甲旁亢手术治疗的安全性与有效性，与年轻患者相似。

【方法】：研究者回顾性分析了898例接受手术治疗的PHPT患者，分为两组：135例老年患者（A组）和763例65岁以下患者（B组）。

【实验】：通过比较两组患者术后的生活质量改善和骨密度（BMD）变化，A组中68.8%的患者出现症状，而B组为81.6%。尽管A组中有0.9%的患者出现了单侧暂时性喉返神经麻痹，而B组中为0.1%，但两组之间差异不大（P > 0.05）。研究中未记录到颈部血肿、死亡或术后主要心血管、神经、呼吸或代谢并发症。一年后随访，所有评估的患者生活质量都有所改善，A组和B组中分别有85.6%和79.8%的患者骨密度增加，症状性与无症状性患者之间无显著差异。研究使用的是单个医疗机构的手术治疗PHPT患者的病例数据。