Minimally Invasive Parathyroidectomy Without Using Intraoperative Parathyroid Hormone Monitoring or Gamma Probe

Overview

Journal Ulus Cerrahi Derg

Specialty General Surgery

Date 2015 May 2

PMID 25931949

Citations 7

Authors

Aykut Soyder

Mustafa Unubol

Imran Kurt Omurlu

Engin Guney

Serdar Ozbas

Affiliations

Soon will be listed here.

Abstract

Objective: Minimal invasive parathyroidectomy (MIP) is a common surgical technique for the treatment of primary hyperparathyroidism (PHPT) and is usually done in conjunction with positive imaging techniques. We aimed to assess the results of this technique, performed without the use of intraoperative tests, in cases with PHPT caused by a single parathyroid adenoma.

Material And Methods: The data for patients who were diagnosed with PHPT were assessed retrospectively. Only those who had undergone a parathyroid adenoma localization study with ultrasonography (US) and parathyroid scintigraphy (PS) before the surgery, along with those patients for whom the MIP technique was routinely performed with frozen pathology, were included.

Results: The study group was made up of 65 patients who had undergone the MIP technique. The mean age of the patients was 56±14 (20-81), with most being females [M/F: 19 (29.2%)/46 (70.8%)]. The mean calcium values before the operation were 11.24±1.26 mg/dL (8-15.5) (normal range: 8.4-10.2), and the parathyroid hormone (PTH) values were 388 pg/mL (249-707.75). These same values, measured 24 hours after the operation, were determined as 9.04±1.04 mg/dL (6.8-13.9) and 27 pg/mL (6-86), respectively. The follow-up period for the patients was an average of 26.6±9.4 (3-76) months, and only 3 (4.6%) cases of persistent hyperparathyroidism were detected within this period.

Conclusion: Our success rate with MIP in PHPT cases was determined to be 95.4%; therefore, this technique may be applied with a high success rate without any assistance from intraoperative tests, such as rapid serum PTH (rPTH) assays or gamma probes, in the presence of localization results of PS and US.

Citing Articles

Findings of pilot study following the implementation of point of care intraoperative PTH assay using whole blood during surgery for primary hyperparathyroidism.

Mohan Kumar R, Pannu A, Metcalfe E, Senbeto M, Balasubramanian S Front Endocrinol (Lausanne). 2023; 14:1198894.

PMID: 37693360 PMC: 10486897. DOI: 10.3389/fendo.2023.1198894.

Endoscopic parathyroidectomy via unilateral axillobreast approach.

Mayir B, Altun K, Erturk M, Ensari C Turk J Surg. 2023; 37(2):188-192.

PMID: 37275189 PMC: 10233931. DOI: 10.47717/turkjsurg.2021.4755.

IS CONFIRMATION OF PARATHYROID TISSUE BY FROZEN SECTION SUPERIOR TO LOCALIZATION OF SOLITARY PARATHYROID ADENOMA USING INTRAOPERATIVE GAMMA PROBE SURVEY? A RETROSPECTIVE COHORT STUDY.

Oner M, Hacim N Acta Endocrinol (Buchar). 2023; 18(4):452-457.

PMID: 37152884 PMC: 10162819. DOI: 10.4183/aeb.2022.452.

Usefulness of the Wisconsin and CaPTHUS indices for predicting multiglandular disease in patients with primary hyperparathyroidism in a southern European population.

Serradilla-Martin M, Palomares-Cano A, Cantalejo-Diaz M, Mogollon-Gonzalez M, Brea-Gomez E, Munoz-Perez N Gland Surg. 2021; 10(3):861-869.

PMID: 33842231 PMC: 8033049. DOI: 10.21037/gs-20-857.

The role of F18-fluorocholine positron emission tomography/magnetic resonance imaging in localizing parathyroid adenomas.

Khafif A, Masalha M, Landsberg R, Domachevsky L, Bernstine H, Groshar D Eur Arch Otorhinolaryngol. 2019; 276(5):1509-1516.

PMID: 30877424 DOI: 10.1007/s00405-019-05301-2.

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