Tratamento cirúrgico do hiperparatiroidismo primário não familiar

  • Ana C. Estevinho Aluna do Mestrado Integrado de Medicina, Faculdade de Medicina da Universidade do Porto Serviço de Cirurgia Geral do Hospital S. João – Centro Hospitalar S. João EPE
  • António Taveira-Gomes Professor Associado Convidado, Faculdade de Medicina do Porto; Assistente Hospitalar Graduado de Cirurgia Geral. Serviço de Cirurgia Geral do Hospital S. João – Centro Hospitalar S. João EPE

Resumo

O hiperparatiroidismo primário é uma doença endócrina comum e a principal causa de hipercalcemia na comunidade. Nas últimas décadas, o número de casos tem aumentado devido à realização de rastreios bioquímicos de rotina com doseamento de cálcio. O diagnóstico é feito, maioritariamente na fase assintomática, através de doseamento de cálcio e PTH. O tratamento cirúrgico representa a única possibilidade de cura. A cirurgia está indicada na maioria dos doentes sintomáticos e em casos selecionados de assintomáticos. Uma vez que até 90% dos casos se devem a adenoma único, e graças aos avanços recentes das técnicas de localização pré-operatória e doseamento intra-operatório da PTH, o tratamento tradicional com exploração bilateral tem vindo a ser substituído pela paratiroidectomia seletiva com taxas de cura e de complicações semelhantes. Existe controvérsia sobre qual o melhor método de localização pré-operatória, monitorização intra-operatória da PTH e a melhor estratégia cirúrgica. A decisão final deve ser baseada no doente, na experiência do cirurgião e nos recursos da instituição.

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Publicado
2014-09-30
Como Citar
ESTEVINHO, Ana C.; TAVEIRA-GOMES, António. Tratamento cirúrgico do hiperparatiroidismo primário não familiar. Revista Portuguesa de Cirurgia, [S.l.], n. 30, p. 27-38, set. 2014. ISSN 2183-1165. Disponível em: <https://revista.spcir.com/index.php/spcir/article/view/414>. Acesso em: 13 nov. 2019.
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Artigos de Revisão