Minimally Invasive Radioguided Parathyroidectomy

CSurgeries ◽  
2020 ◽  
Author(s):  
Joshua Hagood
Keyword(s):  
Minimally Invasive ◽  
Radioguided Parathyroidectomy

Diminished Dose Minimally Invasive Radioguided Parathyroidectomy: A Case for Radioguidance

2007 ◽  
Vol 73 (7) ◽  
pp. 669-672 ◽  
Author(s):  
Christopher J. You ◽  
John L. Zapas
Keyword(s):  
Parathyroid Hormone ◽  
Minimally Invasive ◽  
Frozen Section ◽  
Standard Dose ◽  
Intraoperative Mapping ◽  
Parathyroid Hormone Monitoring ◽  
Frozen Section Analysis ◽  
Radioguided Parathyroidectomy ◽  
Intraoperative Parathyroid Hormone ◽  
Section Analysis

Minimally invasive radioguided parathyroidectomy (MIRP) has been established as an alternative to bilateral neck exploration (BNE) for primary hyperparathyroidism. We investigate whether a diminished dose of technetium-99m sestamibi gives similar results to the standard dose. One hundred one patients were offered MIRP or diminished-dose MIRP (ddMIRP). Patients received intravenous Tc-99m sestamibi at a dose of either 25 mCi 1.5 hours or 5 mCi 1 hour preoperatively. The procedure was terminated when the 20 per cent rule was satisfied. All tissue was confirmed to be parathyroid tissue by frozen section analysis. In addition, intraoperative parathyroid hormone levels were measured in a majority of patients. Patients who failed IOM underwent BNE. Frozen section analysis and intraoperative parathyroid hormone monitoring were also performed in the BNEs. Postoperatively, serum calcium levels were measured at 1 week and 6 months. Fifteen per cent of patients were male and 85 per cent were female. The median age was 63 years (range, 25–89 years). The first 58 patients had the standard dose of 25 mCi, whereas 43 patients had ddMIRP. Six patients (10%) failed intraoperative mapping in the MIRP group and were found to have single-gland disease. Five patients (12%) failed intraoperative mapping in the ddMIRP group. However, two patients were identified to have multigland disease making the true failure rate of intraoperative mapping 7 per cent (three patients). Median operative times for MIRP, ddMIRP, and BNE were 40 minutes, 46 minutes, and 105 minutes, respectively. The 20 per cent rule was satisfied in 96 per cent of patients undergoing MIRP and 98 per cent of patients undergoing ddMIRP. Frozen section analysis and intraoperative parathyroid hormone monitoring did not result in a change in management. Median follow up was 193 days and serum calcium levels at 6 months were normal. Diminished-dose MIRP is a feasible alternative to standard-dose MIRP without compromising surgical outcomes.

Minimally invasive radioguided parathyroidectomy

2006 ◽  
Vol 60 (3) ◽  
pp. 134-138 ◽  
Author(s):  
Domenico Rubello ◽  
Sandro Giannini ◽  
Chiara Martini ◽  
Andrea Piotto ◽  
Lucia Rampin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Radioguided Parathyroidectomy

Minimally invasive radioguided parathyroidectomy in the reoperative neck

Surgery ◽  
1998 ◽  
Vol 124 (6) ◽  
pp. 1088-1093 ◽  
Author(s):  
James Norman ◽  
Daphne Denham
Keyword(s):  
Minimally Invasive ◽  
Radioguided Parathyroidectomy
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