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. 2015 Sep;97(6):420-4.
doi: 10.1308/003588415X14181254790202. Epub 2015 Aug 14.

Ultrasonography alone can reliably locate parathyroid tumours and facilitates minimally invasive parathyroidectomy

H Z Butt  1 , M A Husainy  1 , A Bolia  1 , N J M London  1
Affiliations

Ultrasonography alone can reliably locate parathyroid tumours and facilitates minimally invasive parathyroidectomy

H Z Butt et al. Ann R Coll Surg Engl. 2015 Sep.

Abstract

Introduction: Minimally invasive parathyroidectomy (MIP) is performed via a short incision (≤3cm). Previous studies have employed multiple imaging modalities including ultrasonography, sestamibi imaging and/or intraoperative parathyroid hormone assay. We present our eight-year experience of MIP using ultrasonography alone.

Methods: One hundred parathyroidectomies performed by a single surgeon between April 2004 and December 2012 were identified in a prospectively maintained database. All patients underwent ultrasonography including preoperative marking of the lesion by a single radiologist. No other localising diagnostic tests were performed.

Results: Of the 100 patients (69% female) who underwent parathyroidectomy, 93 had MIP. The median age of all cases was 58 years (range: 19-90 years). All patients exhibited an elevated parathyroid hormone level (median: 19pmol) in the presence of hypercalcaemia (median: 2.86mmol/l, range: 2.54-3.94mmol/l). Conventional surgery was indicated in seven patients owing to the need for concurrent thyroidectomy. The median operative time was 30 minutes (range: 10-130 minutes). Ultrasonography localised parathyroid tumour position correctly in 98% of patients who underwent MIP, and in 97% across both MIP and non-MIP groups. Postoperative complications requiring treatment included pancreatitis and symptomatic hypocalcaemia. Follow-up review at 6-8 weeks demonstrated that 86% of open cases (6/7) and 94% of MIP cases (87/93) were rendered normocalcaemic.

Conclusions: Our study is the first to demonstrate that the sole use of ultrasonography including preoperative marking can localise parathyroid tumours correctly in 98% of cases suitable for MIP.

Keywords: Minimally invasive; Parathyroid glands; Parathyroidectomy; Surgical procedures; Ultrasonography.

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Figures

Figure 1
Figure 1
Transverse (A) and longitudinal (B) views on ultrasonography of a 43-year-old woman with left-sided parathyroid adenoma (arrow) and thyroid gland (star)
Figure 2
Figure 2
Parathyroidectomy outcomes
See this image and copyright information in PMC

References

    1. Ruda JM, Hollenbeak CS, Stack BC. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg 2005; 132: 359–372. - PubMed
    1. Mandl F. Therapeutic attempt for osteitis fibrosa generalisata via the excision of parathyroid tumours. Wien Klin Wochenschr 1925; 38: 1,343–1,344
    1. Udelsman R, Lin Z, Donovan P. The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism. Ann Surg 2011; 253: 585–591. - PubMed
    1. Garimella V, Yeluri S, Alabi A, Samy AK. Minimally invasive video-assisted parathyroidectomy is a safe procedure to treat primary hyperparathyroidism. Surgeon 2012; 10: 202–205. - PubMed
    1. Fouquet T, Germain A, Zarnegar R, et al. . Totally endoscopic lateral parathyroidectomy: prospective evaluation of 200 patients. Langenbecks Arch Surg 2010; 395: 935–940. - PubMed

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