2020, Number 3
Radioguided surgery in the treatment of primary hyperparathyroidism
Language: Spanish
References: 11
Page: 1-14
PDF size: 525.61 Kb.
ABSTRACT
Introduction: Surgical treatment has evolved from bilateral open neck exploration to minimally invasive surgery. Currently, minimally invasive parathyroidectomy in patients with primary hyperparathyroidism is the technique of choice.Objective: To describe the outcomes of surgical treatment of primary hyperparathyroidism with the use of the intraoperative gamma probe.
Methods: A descriptive and longitudinal study of case series was carried out. The sample consisted of 29 patients who received radioguided surgical treatment for primary hyperparathyroidism at Hermanos Ameijeiras Clinical-Surgical Hospital between March 2007 and December 2014.
Results: Of the 29 patients, 21 did not present associated thyroid disease. Their median age was 52 years. They were predominantly female (80.9%). Kidney disease was the most frequent symptom (52.4%). Parathyroid adenoma was the anatomopathological diagnosis with the highest percentage value (85.7%). 38.1% presented postoperative complications and transient hypocalcemia accounted for 28.6%. The mean for postoperative stay was 3.37 days and for healing was 90.5%. In the eight patients with associated thyroid disease, the mean age was 58 years, and there was predominance of the female sex (62.5%). Joint pain and fatigue, accounting for 50%, prevailed as previous symptoms; while parathyroid adenoma, accounting for 62.5%, prevailed as anatomopathological diagnosis. Complications were present in 37.5% and the most frequent was transient hypocalcemia (25.0%). Healing accounted for 62.5% and the mean postoperative stay was 2.47 days.
Conclusions: The results obtained show the usefulness of radioguided surgery in the treatment of primary hyperparathyroidism.
REFERENCES
Rajaei MH, Oltmann SC, Adkisson CD, Elfenbein DM, Chen H, Carty SL, et al. Is intraoperative parathyroid hormone monitoring necessary with ipsilateral parathyroid gland visualization during anticipated unilateral exploration for primary hyperparathyroidism: A two-institution analysis of more than 2000 patients. Surgery. 2014;156 (4):760-8.
Faiz Z, Baas PC, Koopmans KP, Van Tol KM, Van Der Wal JE, Kelder W, et al. Minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: Intra-operative PTH measurements and frozen section analysis are not beneficial in case of positive pre-operative imaging. EJSO. 2014;40(11):S124.