5,000 Parathyroid Operations Without Frozen Section or PTH Assays: Measuring Individual Parathyroid Gland Hormone Production in Real Time
| Autor: | James Norman, Douglas Politz |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adenoma
Adult Male Technetium Tc 99m Sestamibi Parathyroidectomy Pathology medicine.medical_specialty Adolescent medicine.medical_treatment Parathyroid hormone Diagnosis Differential Young Adult medicine Frozen Sections Humans Prospective Studies Child Radionuclide Imaging Aged Aged 80 and over Frozen section procedure Hyperparathyroidism Hyperplasia business.industry Thyroid Middle Aged Hyperparathyroidism Primary Prognosis medicine.disease Parathyroid Neoplasms Treatment Outcome medicine.anatomical_structure Oncology Parathyroid Hormone Female Surgery Parathyroid gland Lymph Nodes Radiopharmaceuticals business Primary hyperparathyroidism Follow-Up Studies Hormone |
| Zdroj: | Annals of Surgical Oncology. 16:656-666 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-008-0276-5 |
| Popis: | Determining the physiologic activity (hormone production) of individual parathyroid glands can provide tremendous guidance during parathyroidectomy. A 6.5-year prospective study of 5,000 patients with sporadic, non-multiple endocrime neoplasia (MEN) primary hyperparathyroidism who underwent surgery without frozen section or parathyroid hormone (PTH) assays was conducted. Patients who had a frozen section were not included; the removal of parathyroid glands was determined solely by the physiologic activity of each gland as determined by contained radioactivity. All operations were within 2.25 hours of sestamibi scanning. Ex vivo measurements of parathyroid glands, thyroid nodules, lymph nodes, thymus, and fat were obtained from all patients, constituting >32,000 specimens. All patients had at least two parathyroid glands evaluated; 59% had four glands evaluated. Ratios were compared with histology and preoperative/postoperative labs. Parathyroid glands occur in three distinct groups according to their hormone production, indicating the type of pathology present. Adenomas (n = 5,120) contained 57 ± 38% of background radioactivity; hyperplastic glands (n = 640) contained 16 ± 4%; and normal glands (n = 9,400) contained 4 ± 0.1% (all p |
| Databáze: | OpenAIRE |
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