Utility of an intraoperative gamma probe in the surgical management of secondary or tertiary hyperparathyroidism
| Autor: | Coen A. Stegeman, Pieter L. Jager, Theo Wiggers, Clara Lemstra, Francisca Hillegonda Jorna, John T. M. Plukker |
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| Přispěvatelé: | Faculteit Medische Wetenschappen/UMCG, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Groningen Kidney Center (GKC), Translational Immunology Groningen (TRIGR) |
| Rok vydání: | 2008 |
| Předmět: |
Parathyroidectomy
medicine.medical_specialty RADIO-GUIDED SURGERY endocrine system diseases medicine.medical_treatment gamma probe PARATHYROID-HORMONE ASSAY Tertiary hyperparathyroidism Scintigraphy parathyroidectomy Parathyroid Glands Intraoperative Period secondary hyperparathyroidism medicine Humans Gamma Cameras Prospective Studies Renal replacement therapy Radionuclide Imaging RADIOGUIDED PARATHYROIDECTOMY Hyperparathyroidism medicine.diagnostic_test business.industry RENAL REPLACEMENT THERAPY GLANDS LOCALIZATION General Medicine medicine.disease Surgery 99M SESTAMIBI Gamma Rays Tc-99m-sestamibi Hyperparathyroidism Secondary Secondary hyperparathyroidism RECURRENT DISEASE SCINTIGRAPHY business REOPERATION Primary hyperparathyroidism Gamma probe |
| Zdroj: | American Journal of Surgery, 196(1), 13-18. EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC |
| ISSN: | 0002-9610 |
| Popis: | BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism.METHODS: The value of the probe in guiding resection of parathyroids was determined prospectively in 29 patients with secondary or tertiary hyperparathyroidism. Resected tissues with radioactivity of greater than 20% as compared with the wound bed was considered hyperfunctional parathyroid and was confirmed histologically.RESULTS: The probe was helpful in guiding resection in 13% of the hyperplastic glands, including ectopic glands and those not detected preoperatively. The gamma probe confirmed the presence of hyperfunctional parathyroid after resection with a sensitivity and specificity of 97% and 92%, respectively.CONCLUSIONS: The probe is particularly useful in confirming the presence of hyperfunctional parathyroids after resection. It also is useful in identifying ectopic localizations, but its value is limited in guiding surgery for secondary or tertiary disease. (c) 2008 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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