| Autor: |
Inabnet III, William B., Kim, Chun K., Haber, Richard S., Lopchinsky, Richard A. |
| Předmět: |
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| Zdroj: |
Archives of Surgery; Aug2002, Vol. 137 Issue 8, p967, 4p |
| Abstrakt: |
Background: Improvements in the accuracy of preoperative localization and the availability of the rapid parathyroid hormone assay have permitted minimally invasive parathyroidectomy in patients with primary hyperparathyoidism. Hypothesis: The use of intraoperative radioguidance is beneficial during targeted parathyroid operations. Design: A retrospective analysis of a prospective database of patients. Setting: Tertiary care referral center. Patients: During a 2½-year period, 130 patients underwent minimally invasive, targeted parathyroidectomy with intraoperative monitoring of the parathyroid hormone level. Of these, 60 patients underwent radioguided parathyroidectomy. Prior to surgery, a solitary parathyroid adenoma was visualized on technetium Tc 99m sestamibi scintigraphy in all patients selected for radioguided parathyroidectomy. A gamma probe was used to guide the surgical dissection. Results: All patients were cured following radioguided parathyroidectomy. In 29 patients (48%), the probe provided confusing or inaccurate information; however, a unilateral neck exploration with excision of a parathyroid adenoma was successfully completed in each of these patients. Forty-three cases were completed under local anesthesia and 85% were discharged home on the same day of surgery. There was 1 temporary recurrent laryngeal nerve palsy. Conclusion: In the era of improved preoperative localization and intraoperative parathyroid hormone monitoring, the routine use of radioguidance is not recommended during parathyroidectomy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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