Management of primary and renal hyperparathyroidism: guidelines from the German Association of Endocrine Surgeons (CAEK)

被引：30

作者：

Weber, T. ^{[1
]}

Dotzenrath, C. ^{[2
]}

Dralle, H. ^{[3
]}

Niederle, B. ^{[4
]}

Riss, P. ^{[4
]}

Holzer, K. ^{[5
]}

Kussmann, J. ^{[6
]}

Trupka, A. ^{[7
]}

Negele, T. ^{[8
]}

Kaderli, R. ^{[9
]}

Karakas, E. ^{[10
]}

Weber, F. ^{[3
]}

Rayes, N. ^{[11
]}

Zielke, A. ^{[12
]}

Hermann, M. ^{[13
]}

Wicke, C. ^{[14
]}

Ladurner, R. ^{[15
]}

Vorlaender, C. ^{[16
]}

Waldmann, J. ^{[17
]}

Heizmann, O. ^{[18
]}

Waechter, S. ^{[5
]}

Schopf, S. ^{[19
]}

Timmermann, W. ^{[20
]}

Bartsch, D. K. ^{[5
]}

Schmidmaier, R. ^{[15
]}

Luster, M. ^{[5
]}

Schmid, K. W. ^{[3
]}

Ketteler, M. ^{[21
]}

Dierks, C. ^{[22
]}

Schabram, P. ^{[23
]}

Steinmueller, T. ^{[24
]}

Lorenz, K. ^{[22
]}

机构：

[1] Katholisches Klinikum, Dept Endocrine Surg, Goldgrube 11, D-55130 Mainz, Germany

[2] HELIOS Univ Klinikum, Wuppertal, Germany

[3] Univ Klinikum Essen, Essen, Germany

[4] Med Univ, Vienna, Austria

[5] Univ Klinikum, Marburg, Germany

[6] Schon Klin, Hamburg, Germany

[7] Klinikum, Starnberg, Germany

[8] Krankenhaus Martha Maria, Munich, Germany

[9] Inselspital Bern, Bern, Switzerland

[10] Alexiander Klin, Krefeld, Germany

[11] Univ Klinikum, Leipzig, Germany

[12] Diakonie Klinikum, Stuttgart, Germany

[13] Krankenanstalt Rudolfstiftung Wien, Vienna, Austria

[14] Kantonsspital, Luzern, Switzerland

[15] LMU Klinikum Univ, Munich, Germany

[16] Burgerhospital, Frankfurt, Germany

[17] MIVENDO Klin, Hamburg, Germany

[18] Diakonieklinikum, Rotenburg, Germany

[19] Romed Klin, Bad Aibling, Germany

[20] Agaples Krankenhaus, Hagen, Germany

[21] Robert Bosch Krankenhaus, Stuttgart, Germany

[22] Univ Klinikum, Halle, Germany

[23] Ratajczak & Partner, Freiburg, Germany

[24] DRK Kliniken, Berlin, Germany

来源：

LANGENBECKS ARCHIVES OF SURGERY | 2021年 / 406卷 / 03期

关键词：

Hyperparathyroidism; Primary hyperparathyroidism; Renal hyperparathyroidism; Parathyroid carcinoma; Guideline; Parathyroidectomy; BILATERAL NECK EXPLORATION; PARATHYROID-HORMONE LEVELS; CHRONIC KIDNEY-DISEASE; HUNGRY BONE SYNDROME; A CONSENSUS REPORT; QUALITY-OF-LIFE; FOLLOW-UP; SECONDARY HYPERPARATHYROIDISM; EUROPEAN-SOCIETY; SURGICAL-MANAGEMENT;

D O I：

10.1007/s00423-021-02173-1

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background and aims The purpose of this review is to provide updated recommendations for the surgical management of primary (pHPT) and renal (rHPT) hyperparathyroidism, formulating a new guideline of the German Association of Endocrine Surgeons (CAEK). Methods Evidence-based recommendations for the diagnosis and therapy of pHPT and rHPT were assessed by a multidisciplinary panel using PubMed for a comprehensive literature search together with a structured consensus dialogue (S2k guideline of the Association of the German Scientific Medical Societies, AWMF). Results During the last 20 years, a variety of new preoperative localization procedures, such as sestamibi-SPECT, 4D-CT, and various PET/CT procedures, were established for pHPT. High-resolution imaging, together with intraoperative parathyroid hormone (IOPTH) measurement, enabled focused or minimally invasive surgery to become the most favored surgical technique. Patients with pHPT and nonlocalizing imaging have a higher risk of multiglandular disease. Surgical therapy provides very high cure rates, with a clear relation to the surgeon's experience in parathyroid procedures. Reoperative parathyroidectomy, children with pHPT or familial forms, and parathyroid carcinoma are addressed and require special surgical expertise. A multidisciplinary team of experienced nephrologists, transplant, and endocrine surgeons should assess the diagnosis and treatment of renal HPT. Conclusion Surgery is the only curative treatment for pHPT and should be considered for all patients with pHPT. For rHPT, a more selective approach is required, and parathyroidectomy is indicated only when conservative treatment options fail. In parathyroid carcinoma, the adequacy of local resection influences local disease control.

引用

页码：571 / 585

页数：15

共 50 条

[1] Management of primary and renal hyperparathyroidism: guidelines from the German Association of Endocrine Surgeons (CAEK)
T. Weber
C. Dotzenrath
H. Dralle
B. Niederle
P. Riss
K. Holzer
J. Kußmann
A. Trupka
T. Negele
R. Kaderli
E. Karakas
F. Weber
N. Rayes
A. Zielke
M. Hermann
C. Wicke
R. Ladurner
C. Vorländer
J. Waldmann
O. Heizmann
S. Wächter
S. Schopf
W. Timmermann
D. K. Bartsch
R. Schmidmaier
M. Luster
K. W. Schmid
M. Ketteler
C. Dierks
P. Schabram
T. Steinmüller
K. Lorenz
[J]. Langenbeck's Archives of Surgery, 2021, 406 : 571 - 585
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J. Waldmann
D. Simon
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R. Ladurner
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[8] Joint Meeting of the German Association of Endocrine Surgeons (CAEK) and the British Association of Endocrine and Thyroid Surgeons (BAETS), Berlin, Germany, November 10-12, 2016 Abstracts
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