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ORIGINAL ARTICLE
Year : 2017  |  Volume : 32  |  Issue : 3  |  Page : 184-187

Radio-guided minimally invasive parathyroidectomy: A descriptive report of the experience from tertiary center in Bangalore


1 Department of Head and Neck Surgical Oncology, Diabetes and Metabolism, Narayana Health City, Bangalore, Karnataka, India
2 Department of Nuclear Medicine, Diabetes and Metabolism, Narayana Health City, Bangalore, Karnataka, India
3 Department of Endocrinology, Diabetes and Metabolism, Narayana Health City, Bangalore, Karnataka, India

Correspondence Address:
Subramanian Kannan
Consultant and Head of Department Endocrinology, Diabetes and Metabolism, Narayana Health City Bangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnm.IJNM_9_17

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Overview: Minimally invasive parathyroidectomy (MIP) is an accepted surgical procedure for parathyroid adenomas. In the patients with parathyroid adenoma localized by dual phase 99mTc-Sestamibi scan, a focused approach utilizing the gamma probe intra-operatively helps in ensuring complete resection and avoiding exploration of the other parathyroid glands. Objective: The aim of the study was to evaluate the performance of radio-guided MIP for parathyroid adenomas detected by dual phase 99mTc-MIBI preoperatively, without intra-operative parathyroid hormone (ioPTH) monitoring for patients who had evidence of single-gland disease. Patients and Methods: A retrospective dataset of 30 patients diagnosed with solitary parathyroid adenoma operated between 2009 and 2014 were reviewed. All of the patients underwent radio-guided MIP and were followed up for at least 6 months post-operatively. The biochemical parameters (serum calcium and serum parathyroid hormone levels), imaging parameters (ultrasonography and 99mTc-MIBI), and operative times were analyzed. Results: Our study consisted of 30 patients with 50% females, with a mean age of 42.5 + 12 years. The mean surgical duration was 20 + 12 min. All of the patients achieved biochemical cure (normalization of serum calcium) and remained eucalcemic at follow-up. No major surgical complications were noted. Conclusions: Focused parathyroidectomy using the gamma probe localization could be a potential alternative for ioPTH assay in ensuring the completeness of surgical resection of parathyroid adenoma. It is also likely to shorten operative time.


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