Intraoperative ultrasound imaging and sono-scintigraphic concordance improves success rates of minimally invasive parathyroidectomy
| Autor: | Rabiye Uslu Erdemir, Guldeniz Karadeniz Cakmak, Ilhan Tasdoven, Taner Bayraktaroglu |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Technetium Tc 99m Sestamibi medicine.medical_specialty Adenoma Concordance Scintigraphy medicine Humans Minimally Invasive Surgical Procedures Radionuclide Imaging Aged Retrospective Studies Ultrasonography Parathyroid adenoma Parathyroidectomy Frozen section procedure medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Parathyroid Neoplasms Parathyroid Hormone Female Radiology business Minimally invasive parathyroidectomy Primary hyperparathyroidism |
| Zdroj: | TURKISH JOURNAL OF MEDICAL SCIENCES. 51:2341-2345 |
| ISSN: | 1303-6165 |
| DOI: | 10.3906/sag-2101-126 |
| Popis: | Introduction This study aimed to evaluate the effect of sono-scintigraphic correlation on the success of minimal invasive parathyroidectomy (MIP) via surgeon performed continuous intraoperative sonographic guidance in patients operated for primary hyperparathyroidism(PHPT) without intact parathormone (PTH) measurement. Materials and methods A retrospective analysis of a prospective database was conducted to review patients who underwent MIP (July 2017-October 2019). The screened parameters were preoperative PTH level, preoperative ultrasonography (US), preoperative scintigraphy, intraoperative US, intraoperative frozen section analysis, postoperative PTH level and permanent pathology report. Intraoperative intact PTH measurement was not employed due to institutional policy. Results Preoperative US alone localized the specific side (right/left, inferior/superior) of abnormality in 54 out of 74 (72.97%) cases. Scintigraphy alone localized the specific side in 58 (78.37%) cases. The sensitivity of preoperative US and scintigraphy alone was 76.05% and 86.56%, respectively. Sono-scintigraphic discordance was present in 6 cases (8.1%) and intraoperative real-time US predicted accurate localization of adenoma in 4 (66.6%) and scintigraphy in 2 (44.4%) patients. The frozen section analysis confirmed parathyroid cells in all cases evaluated. Conclusion Sono-scintigraphic concordance with intraoperative real-time imaging increases surgical success rates in cases where MIP is planned under the circumstances of limited resources regarding unavailability of intact PTH measurement. |
| Databáze: | OpenAIRE |
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