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Medical and Surgical Treatment of Parathyroid Diseases pp 181–201Cite as

Minimally Invasive Radioguided Parathyroidectomy

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Abstract

Minimally invasive radioguided parathyroidectomy (MIRP) has gained mainstream popularity as a surgical treatment option for primary hyperparathyroidism (1° HPT) caused by a solitary parathyroid adenoma. Compared to the gold standard bilateral neck exploration with parathyroidectomy, advantages of MIRP include shorter operative times, smaller surgical incisions and resulting scars, cost savings, and fewer complications. Imaging techniques remain imperfect, but technological advancements have allowed for continual improvement in the rate of successful preoperative localization of diseased parathyroid glands. Use of 99mTc-sestamibi radionuclide and a handheld gamma probe for intraoperative measurement of sequestered radioactivity allows reliable distinction of parathyroid adenomas from fat, lymph nodes, and normal parathyroid glands. Intraoperative parathyroid hormone (IOPTH) measurement allows for intraoperative confirmation that parathyroid hormone (PTH) levels have been corrected by removal of the offending parathyroid adenoma. In cases where MIRP is technically possible, the rate of cure of 1° HPT is comparable to that of bilateral neck exploration with parathyroidectomy.

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Authors and Affiliations

  1. Department of Otolaryngology—Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 W. Markham St., Box 543, Little Rock, AR, 72205, USA

    Matthew D. Cox M.D. & Brendan C. Stack Jr. M.D.

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  2. Brendan C. Stack Jr. M.D.
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Correspondence to Brendan C. Stack Jr. M.D. .

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  1. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Brendan C. Stack, Jr.

  2. Department of Geniatrics and Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Donald L. Bodenner

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Cox, M.D., Stack, B.C. (2017). Minimally Invasive Radioguided Parathyroidectomy. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_17

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  • DOI: https://doi.org/10.1007/978-3-319-26794-4_17

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  • Print ISBN: 978-3-319-26792-0

  • Online ISBN: 978-3-319-26794-4

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