手术治疗继发性甲状旁腺功能亢进症多学科诊疗的争议与协作OA

The multi-disciplinary team(MDT)care centered on parathyroidectomy(PTX)has gradually become the main treatment model for secondary hyperparathyroidism(SHPT).However,different departments such as surgery,nephrology,laboratory medicine,radiology,and endocrinology have varying understandings and treatment strategies for SHPT.This article,from a surgical perspective,reviewed the controversies and collaborations in MDT during the diagnosis and treatment of SHPT,including disputes with nephrology over the timing of surgery and treatment goals,collaboration with radiology for preoperative localization,collaboration with laboratory medicine for intraoperative monitoring of parathyroid hormone,collaboration with intensive care units,endocrinology,and cardiology in the management of complications such as electrolyte disorders,bone hunger syndrome,and cardiovascular events during the perioperative period,as well as disputes with the metabolic department regarding the evaluation of postoperative bone metabolism changes.This provided a reference for the clinical promotion of MDT diagnosis and treatment of SHPT.