Minimally invasive parathyroidectomy facilitated by intraoperative nuclear mapping

Surgery
J Norman, H Chheda

Abstract

The inability to predict the location and number of diseased parathyroid glands has precluded the wide acceptance of unilateral neck exploration for primary hyperparathyroidism. We used intraoperative nuclear mapping in patients identified by sestamibi scanning to have a single adenoma in hopes of minimizing operative intervention while maintaining the efficacy of a full exploration. Fifteen consecutive patients with primary hyperparathyroidism underwent technetium 99m-labeled sestamibi scanning 3.0 +/- 0.1 hours before operation. Placement of the initial 2.0 cm incision and all dissection were guided by quantitative gamma counting in four neck quadrants with an 11 mm Neoprobe. Ex vivo radioactivity was determined for parathyroid glands, fat, and lymph nodes. Potential radiation hazards were assessed. Intraoperative nuclear mapping discriminated between 14 solitary adenomas and one patient with four-gland hyperplasia that was not predicted on preoperative sestamibi scanning. Removal of the adenoma resulted in a decline in radioactivity in that quadrant (p < 0.001) and the entire neck (p < 0.05), with equalization of all neck quadrants. Ex vivo counts always identified parathyroid tissue (p < 0.0001 versus fat and lymph node). A...Continue Reading

References

Aug 1, 1990·Archives of Surgery·R J LucasJ L Glover
Oct 1, 1990·American Journal of Surgery·L J AugusteD Schnaap
May 1, 1990·World Journal of Surgery·C F RussellW R Ferguson
Oct 1, 1993·American Journal of Surgery·K S HellerS Dubner
Dec 1, 1996·American Journal of Surgery·A MalhotraL M Freeman

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Citations

Apr 10, 2004·Annals of Nuclear Medicine·Shigeyuki OgiHiroshi Takeyama
Sep 17, 2002·Annals of Nuclear Medicine·N O KüçükG Aras
Oct 13, 2006·European Journal of Nuclear Medicine and Molecular Imaging·Domenico Rubello, Giuliano Mariani
Mar 14, 2007·European Journal of Nuclear Medicine and Molecular Imaging·Domenico RubelloAdil AL-Nahhas
May 28, 2009·European Journal of Nuclear Medicine and Molecular Imaging·Elif HindiéUNKNOWN Parathyroid Task Group of the EANM
Apr 30, 2010·European Journal of Nuclear Medicine and Molecular Imaging·Paloma García-TalaveraAlberto Gómez
Aug 22, 2008·Langenbeck's Archives of Surgery·Jean-François Henry
Jul 11, 2009·Langenbeck's Archives of Surgery·Barney J Harrison, Frederic Triponez
Jun 8, 2001·Surgical Endoscopy·K K HallfeldtK Horn
Mar 25, 2010·Annals of Nuclear Medicine·Yoshifumi IkedaHiroshi Takami
Apr 1, 2010·Indian Journal of Surgical Oncology·Jean-François Henry, Abhijit Thakur
Dec 16, 2003·American Journal of Surgery·Lee C PedersonJeffrey E Lee
May 1, 2004·Joint, Bone, Spine : Revue Du Rhumatisme·David MalinvaudRémi Marianowski
Feb 6, 2007·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·James Norman, Kelly Aronson
Feb 4, 2006·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Omer UgurIskender Sayek
May 28, 2008·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Tam-Lin ChowSiu-Ho Lam
Aug 22, 2001·American Journal of Surgery·P MiccoliD Galleri
Nov 4, 2000·The Surgical Clinics of North America·J R Howe
Dec 20, 2000·Current Surgery·J A Singer
Feb 20, 2004·Current Surgery·Thomas A Broughan
Feb 20, 2004·Current Surgery·Scott M Wilhelm, Jerry M Shuck
Jul 29, 2000·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Y Ikeda, H Takami
Dec 19, 2002·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Hiroshi Takami
Oct 18, 2000·Endocrinology and Metabolism Clinics of North America·M S Eigelberger, O H Clark
Jul 18, 2000·Journal of the American College of Surgeons·M B FlynnK M McMasters
Dec 29, 2000·Journal of the American College of Surgeons·P MiccoliG Materazzi
Jul 13, 2002·Journal of the American College of Surgeons·Rauni A SaaristoIsto H Nordback
Mar 3, 1998·Journal of the American College of Surgeons·J A van Heerden
Feb 19, 1999·Journal of the American College of Surgeons·E L Kaplan
Jul 2, 2009·The Journal of Laryngology and Otology·C E B GiddingsN Weir
Jan 6, 1999·The British Journal of Surgery·F PattouC Proye
Dec 14, 1999·The British Journal of Surgery·P G GaugerL W Delbridge
Apr 25, 2000·The Australian and New Zealand Journal of Surgery·T S ReeveG J Maddern
Jun 21, 2002·ANZ Journal of Surgery·Gaurav AgarwalLeigh W Delbridge

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