Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery
Background. Minimally invasive parathyroidectomy (MIP) is increasingly replacing the traditional bilateral neck exploration in the treatment of primary hyperparathyroidism (PHP). Intraoperative PTH (IOPTH) measurement has recently been introduced as a useful adjunct in confirming successful excision...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2010-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2010/178671 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832564193302151168 |
|---|---|
| author | E. Ypsilantis H. Charfare W. S. Wassif |
| author_facet | E. Ypsilantis H. Charfare W. S. Wassif |
| author_sort | E. Ypsilantis |
| collection | DOAJ |
| description | Background. Minimally invasive parathyroidectomy (MIP) is increasingly replacing the traditional bilateral neck exploration in the treatment of primary hyperparathyroidism (PHP). Intraoperative PTH (IOPTH) measurement has recently been introduced as a useful adjunct in confirming successful excision of abnormal parathyroid gland. Aims. We evaluate the safety, efficacy, and clinical usefulness of IOPTH measurement during MIP in a district general hospital. Methods. Retrospective review of eleven consecutive patients with PHP who underwent MIP with IOPTH, following preoperative assessment with ultrasound and sestamibi scans. Results. All patients had successful removal of the abnormal parathyroid gland. The concordance rate between ultrasound and sestamibi scan in localising the parathyroid adenoma was 82%. IOPTH measurement confirmed the removal of adenoma in all cases and, in one case, led to identification of a second adenoma, not localised preoperatively. The median hospital stay was 2 days (range 1–7 days). All patients remained normocalcaemic after a median of 6 months (range 1–10 months). Conclusions. Minimally invasive parathyroidectomy is a feasible, safe, and effective method for treatment of PHP. The use of IOPTH monitoring potentially offers increased sensitivity in detecting multiglandular disease, can minimise the need and risk associated with recurrent operations, and may facilitate cost-effective minimally invasive surgery. |
| format | Article |
| id | doaj-art-585b7ae43f864c07b631ffa61f7782d5 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-585b7ae43f864c07b631ffa61f7782d52025-02-03T01:11:36ZengWileyInternational Journal of Endocrinology1687-83371687-83452010-01-01201010.1155/2010/178671178671Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent SurgeryE. Ypsilantis0H. Charfare1W. S. Wassif2Princess Royal University Hospital, Farnborough Common, London BR6 8ND, UKBedford Hospital South Wing, Kempston Road, Bedford MK42 9DJ, UKBedford Hospital South Wing, Kempston Road, Bedford MK42 9DJ, UKBackground. Minimally invasive parathyroidectomy (MIP) is increasingly replacing the traditional bilateral neck exploration in the treatment of primary hyperparathyroidism (PHP). Intraoperative PTH (IOPTH) measurement has recently been introduced as a useful adjunct in confirming successful excision of abnormal parathyroid gland. Aims. We evaluate the safety, efficacy, and clinical usefulness of IOPTH measurement during MIP in a district general hospital. Methods. Retrospective review of eleven consecutive patients with PHP who underwent MIP with IOPTH, following preoperative assessment with ultrasound and sestamibi scans. Results. All patients had successful removal of the abnormal parathyroid gland. The concordance rate between ultrasound and sestamibi scan in localising the parathyroid adenoma was 82%. IOPTH measurement confirmed the removal of adenoma in all cases and, in one case, led to identification of a second adenoma, not localised preoperatively. The median hospital stay was 2 days (range 1–7 days). All patients remained normocalcaemic after a median of 6 months (range 1–10 months). Conclusions. Minimally invasive parathyroidectomy is a feasible, safe, and effective method for treatment of PHP. The use of IOPTH monitoring potentially offers increased sensitivity in detecting multiglandular disease, can minimise the need and risk associated with recurrent operations, and may facilitate cost-effective minimally invasive surgery.http://dx.doi.org/10.1155/2010/178671 |
| spellingShingle | E. Ypsilantis H. Charfare W. S. Wassif Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery International Journal of Endocrinology |
| title | Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery |
| title_full | Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery |
| title_fullStr | Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery |
| title_full_unstemmed | Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery |
| title_short | Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery |
| title_sort | intraoperative pth assay during minimally invasive parathyroidectomy may be helpful in the detection of double adenomas and may minimise the risk of recurrent surgery |
| url | http://dx.doi.org/10.1155/2010/178671 |
| work_keys_str_mv | AT eypsilantis intraoperativepthassayduringminimallyinvasiveparathyroidectomymaybehelpfulinthedetectionofdoubleadenomasandmayminimisetheriskofrecurrentsurgery AT hcharfare intraoperativepthassayduringminimallyinvasiveparathyroidectomymaybehelpfulinthedetectionofdoubleadenomasandmayminimisetheriskofrecurrentsurgery AT wswassif intraoperativepthassayduringminimallyinvasiveparathyroidectomymaybehelpfulinthedetectionofdoubleadenomasandmayminimisetheriskofrecurrentsurgery |