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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/11/13 15:50:14」(JST)

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Parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone. As drugs such as Fosamax do not treat the underlying cause of parathyroid-related osteoporosis, surgery is the only cure. Bone loss is reversible.

The location of the glands is generally behind the thyroid, but there is a lot of variation. Usually, the location of an enlarged gland has been confirmed via a sestamibi scan or on ultrasound.

Procedure

During the operation, the patient is usually put under a general anesthetic (unconscious and pain free) or a local anesthetic (pain free). The surgeon makes an incision around an inch long in the neck just under the Adam's apple and locates the offending parathyroid glands. Preoperative testing using sestamibi scanning can help identify the location of glands. It can also be used to limit the extent of surgical exploration when used in conjunction with intraoperative PTH hormone monitoring.^[1] The particular problem or disease process will determine how many of the parathyroid glands are removed. Some parathyroid tissue must be left in place to help prevent hypoparathyroidism

The patient usually recovers very quickly after the operation. The PTH level is back to normal within 10–15 minutes, and is confirmed by intraoperative rapid assessment during the operation. However, the remaining parathyroid glands may take hours to several weeks to return to their normal functioning levels. Patients must be placed on calcium supplements to prevent symptoms of hypocalcemia and to restore lost bone mass.

References

^ Augustine, MM; Bravo, PE; Zeiger, MA (Mar–Apr 2011). "Surgical treatment of primary hyperparathyroidism.". Endocrine Practice. 17 Suppl 1: 75–82. doi:10.4158/EP10359.RA. PMID 21324817.

Lee, J.A. (2006-10-16). "Parathyroidectomy". Medical Encyclopedia. Medline Plus. Retrieved 2007-11-02.

Nanka O, Sedý J, Vítková I, Libánský P, Adámek S (2006). "Surgical anatomy of parathyroid glands with emphasis on parathyroidectomy". Prague Med Rep. 107 (2): 261–72. PMID 17066745.

External links

Information from the American Association of Endocrine Surgeons

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1. 副甲状腺摘出後の飢餓骨症候群 hungry bone syndrome following parathyroidectomy
2. 末期腎不全における副甲状腺摘出の適応 indications for parathyroidectomy in end stage renal disease
3. 原発性副甲状腺機能亢進症の副甲状腺診査 parathyroid exploration for primary hyperparathyroidism
4. 原発性副甲状腺機能亢進症：マネージメント primary hyperparathyroidism management
5. 原発性副甲状腺機能亢進症患者における副甲状腺手術における術前局在診断 preoperative localization for parathyroid surgery in patients with primary hyperparathyroidism

English Journal

Treatment of secondary hyperparathyroidism with parathyroidectomy instead of cinacalcet: time to pick the low-hanging fruit?

Yuan CM, Nee R, Narayan R, Abbott KC.SourceWalter Reed National Military Medical Center, Bethesda, Maryland.
American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2012 Aug;60(2):179-81.
PMID 22805518

Cost-effectiveness of cinacalcet hydrochloride for hemodialysis patients with severe secondary hyperparathyroidism in Japan.

Komaba H, Moriwaki K, Goto S, Yamada S, Taniguchi M, Kakuta T, Kamae I, Fukagawa M.SourceDivision of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan; Division of Nephrology and Kidney Center, Kobe University School of Medicine, Kobe, Japan.
American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2012 Aug;60(2):262-71. Epub 2012 Mar 24.
BACKGROUND: Cinacalcet effectively reduces elevated levels of parathyroid hormone (PTH) in patients with secondary hyperparathyroidism (SHPT), even those with severe disease for whom parathyroidectomy can be the treatment of choice. The objective of this study was to estimate the cost-effectiveness
PMID 22445709

Japanese Journal

重度な進行性の臨床経過をたどった副甲状腺がんの1例

森博子,岡田洋右,新生忠司,田中良哉
産業医科大学雑誌 36(4), 243-249, 2014-12-01
骨粗粒症,脳梗塞,高カルシウム血症,そして高parathyroid hormone (PTH)血症を呈した59歳女性について報告する.原発性副甲状腺機能亢進症と診断され,副甲状腺摘出術を施行された.病理学的所見では,副甲状腺腺腫の結果であったが,副甲状腺摘出2年後,3年後に副甲状腺腫大を来し,4年後には肺にも転移し,臨床経過および再摘出病理より副甲状腺癌の再発と診断された.ビスホスホネート静注療法 …
NAID 110009878654

腎移植後遷延性副甲状腺機能先進症に対する副甲状腺全摘前腕筋肉内自家移植術の意義

山本貴之,冨永芳博,岡田学 [他]
日本臨床腎移植学会雑誌 = Journal of Japanese Society for Clinical Renal Transplantation 2(2), 180-183, 2014-12
NAID 40020446493

高齢者の原発性副甲状腺機能亢進症の臨床的検討

古屋舞,池田達彦,澤文 [他]
日本内分泌・甲状腺外科学会雑誌 = Official journal of the Japan Association of Endocrine Surgeons and the Japanese Society of Thyroid Surgery 31(3), 219-222, 2014-09
NAID 40020211083

Related Pictures

The role of focused parathyroidectomy - For Medical Professionals - Mayo Clinic Parathyroidectomy - Wikipedia Parathyroidectomy: Identifying the Recurrent Laryngeal Nerve | Falconieri Visuals Parathyroidectomy: Surgical removal of one or more parathyroid glands - Update - www Minimally Invasive Parathyroid Surgery - Thyroid Sydney Parathyroid Surgery | Cleveland Clinic The role of focused parathyroidectomy - For Medical Professionals - Mayo Clinic

★リンクテーブル★

リンク元	「上皮小体摘出」「副甲状腺切除」「副甲状腺摘出」「副甲状腺切除術」「副甲状腺摘出術」

「上皮小体摘出」

Parathyroidectomy
	Intervention
	Parathyroidectomy for parathyroid adenoma
ICD-9-CM	06.8
MeSH	D016105
	[edit on Wikidata]

　　[★]

英: parathyroidectomy
関: 副甲状腺切除、副甲状腺摘出、副甲状腺摘出術、副甲状腺切除術

「副甲状腺切除」

　　[★]

英: parathyroidectomy
関: 副甲状腺摘出、副甲状腺摘出術、副甲状腺切除術、上皮小体摘出

「副甲状腺摘出」

　　[★]

英: parathyroidectomy
関: 副甲状腺切除、副甲状腺摘出術、副甲状腺切除術、上皮小体摘出

「副甲状腺切除術」

　　[★]

英: parathyroidectomy
関: 副甲状腺切除、副甲状腺摘出、副甲状腺摘出術、上皮小体摘出

「副甲状腺摘出術」

　　[★]

英: parathyroidectomy
関: 副甲状腺切除、副甲状腺摘出、副甲状腺切除術、上皮小体摘出

[1] Augustine, MM; Bravo, PE; Zeiger, MA (Mar–Apr 2011). "Surgical treatment of primary hyperparathyroidism.". Endocrine Practice. 17 Suppl 1: 75–82. doi:10.4158/EP10359.RA. PMID 21324817.

v t e Surgery involving the endocrine system (ICD-9-CM V3 06–07, ICD-10-PCS 0G)

Pancreas	Islet cell transplantation see also digestive system procedures

Pituitary	Hypophysectomy Transsphenoidal surgery Combined rapid anterior pituitary evaluation panel

Thyroid	Thyroidectomy Parathyroidectomy Tests Radioactive iodine uptake test Sestamibi parathyroid scan TRH stimulation test

Adrenal gland	Adrenalectomy Tests Dexamethasone suppression test ACTH stimulation test Captopril suppression test Fluid deprivation test

Pineal gland	Pinealectomy

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parathyroidectomy