{"id":106277,"date":"2018-03-11T10:30:10","date_gmt":"2018-03-11T10:30:10","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/ciruga%c2%ada-ma%c2%adnimamente-invasiva-en-el-hiperparatiroidismo-primario\/"},"modified":"2018-03-11T10:30:10","modified_gmt":"2018-03-11T10:30:10","slug":"ciruga%c2%ada-ma%c2%adnimamente-invasiva-en-el-hiperparatiroidismo-primario","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/ciruga%c2%ada-ma%c2%adnimamente-invasiva-en-el-hiperparatiroidismo-primario\/","title":{"rendered":"Cirugia m\u00ednimamente invasiva en el hiperparatiroidismo primario."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Santiago Alonso Gomez <\/strong><\/h2>\n<p>Introducci\u00f3n  la mayor precisi\u00f3n en la localizaci\u00f3n preoperatoria y utilizaci\u00f3n de complementos intraoperatorios han permitido avanzar hacia una paratiroidectom\u00eda selectiva. La paratiroidectom\u00eda tiene un efecto beneficioso sobre la densidad mineral \u00f3 sea y la normalizaci\u00f3n de los marcadores de remodelado \u00f3seo a largo plazo.  material y m\u00e9todos  en este estudio prospectivo y aleatorizado se incluyeron 53 pacientes, divididos en dos grupos. El primer grupo se caracteriz\u00f3 por el empleo de las determ inaci\u00f3n intraoperatoria de pth y el segundo grupo qued\u00f3 definido por la utilizaci\u00f3n de la sonda gammadetectora intraoperatoria. En la primera parte del estudio se realiz\u00f3 un an\u00e1lisis comparativo y descriptivo de las distintas variables entre los dos grupos. En la segunda parte del estudio se recogieron par\u00e1metros bioqu\u00edmicos, marcadores de remodelado \u00f3seo, par\u00e1metros densitom\u00e9tricos, ultraestructurales e inmunohistoqu\u00edmicos, realiz\u00e1ndose un seguimiento postquir\u00fargico a 5 a\u00f1os tras la paratiroide ctom\u00eda.  resultados y conclusiones  un resultado coincidente de la gammagraf\u00eda y de la ecograf\u00eda permite establecer el diagn\u00f3stico de adenoma \u00fanico en un 96.23 . La determinaci\u00f3n intraoperatoria de la pth, as\u00ed como la utilizaci\u00f3n intraoperatoria de l a sonda gammadetectora, son t\u00e9cnicas altamente fiables para corroborar una resecci\u00f3n adecuada (93  y 86.96 ), sin existir diferencias estad\u00edsticamente significativas entre ambas (p=0.256). Los marcadores de remodelado \u00f3seo se encuentran elevados de m anera preoperatoria en los pacientes con hiperparatiroidismo primario, descendiendo tras la paratiroidectom\u00eda de manera significativa hasta valores normales en un seguimiento a cinco a\u00f1os. Existe una correlaci\u00f3n estad\u00edsticamente significativa entre l os valores preoperatorios de la pth, osteocalcina y fosfatasa alcalina \u00f3sea, y el porcentaje de cambio de la densidad mineral \u00f3sea lumbar. Tras la paratiroidectom\u00eda se produce un aumento de la densidad mineral \u00f3sea lumbar, as\u00ed como un salto de escal\u00f3 n en la t-score desde el grado osteopor\u00f3tico (-2.515) hasta el grado osteop\u00e9nico (-1.5), con la consiguiente disminuci\u00f3n del riesgo de fractura.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Cirugia m\u00ednimamente invasiva en el hiperparatiroidismo primario.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Cirugia m\u00ednimamente invasiva en el hiperparatiroidismo primario. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Santiago Alonso Gomez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Complutense de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 14\/01\/2011<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Eduardo Ferrero Herrero<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Jes\u00fas \u00e1lvarez fern\u00e1ndez-represa <\/li>\n<li>Jos\u00e9 Manuel Figueroa andollo (vocal)<\/li>\n<li>Jos\u00e9 Antonio Rodr\u00edguez montes (vocal)<\/li>\n<li>eduardo enrique Rubio gonz\u00e1lez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Santiago Alonso Gomez Introducci\u00f3n la mayor precisi\u00f3n en la localizaci\u00f3n preoperatoria y utilizaci\u00f3n de complementos intraoperatorios han [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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