Langenbeck's Archives of Surgery

, Volume 394, Issue 5, pp 799–809 | Cite as

Intraoperative adjuncts in surgery for primary hyperparathyroidism

Current Concepts in Endocrine Surgery

Abstract

Purpose

This paper is a review of the evidence base to produce recommendations for the use of intraoperative parathyroid hormone (PTH), radioguided parathyroidectomy (RGP), methylene blue (MB), frozen section, and intraoperative neuromonitoring during surgery for primary hyperparathyroidism (PHPT).

Materials and methods

A Medline keyword search of English-language articles led to the production of a draft document, subsequently revised by committee, containing levels of evidence and the grading of recommendations as proposed by the Agency for Healthcare Research and Quality.

Results

Literature review provides the basis for clear recommendations on the use of intraoperative PTH at surgery for PHPT. There is little evidence to support the use of RGP, MB, routine frozen section, and intraoperative neuromonitoring.

Keywords

Intraoperative PTH Radioguided parathyroidectomy Methylene blue Frozen section Intraoperative neuromonitoring Parathyroidectomy 

References

  1. 1.
    Sackett WR, Barraclough B, Reeve TS, Delbridge LW (2002) Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 137(9):1055–1059PubMedCrossRefGoogle Scholar
  2. 2.
    Sharma J, Milas M, Berber E, Mazzaglia P, Siperstein A, Weber CJ (2008) Value of intraoperative parathyroid hormone monitoring. Ann Surg Oncol 15(2):493–498PubMedCrossRefGoogle Scholar
  3. 3.
    Miccoli P, Berti P, Materazzi G, Ambrosini CE, Fregoli L, Donatini G (2008) Endoscopic bilateral neck exploration versus quick intraoperative parathormone assay (qPTHa) during endoscopic parathyroidectomy: a prospective randomized trial. Surg Endosc 22(2):398–400PubMedCrossRefGoogle Scholar
  4. 4.
    Barczynski M, Cichon S, Konturek A, Cichon W (2006) Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial. World J Surg 30(5):721–731PubMedCrossRefGoogle Scholar
  5. 5.
    Baliski CR, Stewart JK, Anderson DW, Wiseman SM, Bugis SP (2005) Selective unilateral parathyroid exploration: an effective treatment for primary hyperparathyroidism. Am J Surg 189(5):596–600 discussion 600PubMedCrossRefGoogle Scholar
  6. 6.
    Sidhu S, Neill AK, Russell CF (2003) Long-term outcome of unilateral parathyroid exploration for primary hyperparathyroidism due to presumed solitary adenoma. World J Surg 27(3):339–342PubMedCrossRefGoogle Scholar
  7. 7.
    Russell CF, Dolan SJ, Laird JD (2006) Randomized clinical trial comparing scan-directed unilateral versus bilateral cervical exploration for primary hyperparathyroidism due to solitary adenoma. Br J Surg 93(4):418–421PubMedCrossRefGoogle Scholar
  8. 8.
    Udelsman R, Donovan PI (2004) Open minimally invasive parathyroid surgery. World J Surg 28(12):1224–1226PubMedCrossRefGoogle Scholar
  9. 9.
    Bergson EJ, Sznyter LA, Dubner S, Palestro CJ, Heller KS (2004) Sestamibi scans and intraoperative parathyroid hormone measurement in the treatment of primary hyperparathyroidism. Arch Otolaryngol Head Neck Surg 130(1):87–91PubMedCrossRefGoogle Scholar
  10. 10.
    Carneiro-Pla DM, Solorzano CC, Irvin GL 3rd (2006) Consequences of targeted parathyroidectomy guided by localization studies without intraoperative parathyroid hormone monitoring. J Am Coll Surg 202(5):715–722PubMedCrossRefGoogle Scholar
  11. 11.
    Nilsen FS, Haug E, Heidemann M, Karlsen SJ (2006) Does rapid intraoperative parathyroid hormone analysis predict cure in patients undergoing surgery for primary hyperparathyroidism? A prospective study. Scand J Surg 95(1):28–32PubMedGoogle Scholar
  12. 12.
    Gil-Cardenas A, Gamino R, Reza A, Pantoja JP, Herrera MF (2007) Is intraoperative parathyroid hormone assay mandatory for the success of targeted parathyroidectomy? J Am Coll Surg 204(2):286–290PubMedCrossRefGoogle Scholar
  13. 13.
    Stalberg P, Sidhu S, Sywak M, Robinson B, Wilkinson M, Delbridge L (2006) Intraoperative parathyroid hormone measurement during minimally invasive parathyroidectomy: does it “value-add” to decision-making? J Am Coll Surg 203(1):1–6PubMedCrossRefGoogle Scholar
  14. 14.
    Gawande AA, Monchik JM, Abbruzzese TA, Iannuccilli JD, Ibrahim SI, Moore FD Jr (2006) Reassessment of parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism after 2 preoperative localization studies. Arch Surg 141(4):381–384 discussion 384PubMedCrossRefGoogle Scholar
  15. 15.
    Mihai R, Palazzo FF, Gleeson FV, Sadler GP (2007) Minimally invasive parathyroidectomy without intraoperative parathyroid hormone monitoring in patients with primary hyperparathyroidism. Br J Surg 94(1):42–47PubMedCrossRefGoogle Scholar
  16. 16.
    Pang T, Stalberg P, Sidhu S, Sywak M, Wilkinson M, Reeve TS, Delbridge L (2007) Minimally invasive parathyroidectomy using the lateral focused mini-incision technique without intraoperative parathyroid hormone monitoring. Br J Surg 94(3):315–319PubMedCrossRefGoogle Scholar
  17. 17.
    Lew JI, Solorzano CC, Montano RE, Carneiro-Pla DM, Irvin GL 3rd (2008) Role of intraoperative parathormone monitoring during parathyroidectomy in patients with discordant localization studies. Surgery 144(2):299–306PubMedCrossRefGoogle Scholar
  18. 18.
    Barczynski M, Konturek A, Cichon S, Hubalewska-Dydejczyk A, Golkowski F, Huszno B (2007) Intraoperative parathyroid hormone assay improves outcomes of minimally invasive parathyroidectomy mainly in patients with a presumed solitary parathyroid adenoma and missing concordance of preoperative imaging. Clin Endocrinol (Oxf) 66(6):878–885CrossRefGoogle Scholar
  19. 19.
    Ito F, Sippel R, Lederman J, Chen H (2007) The utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing. Ann Surg 245(6):959–963PubMedCrossRefGoogle Scholar
  20. 20.
    Irvin GL 3rd, Solorzano CC, Carneiro DM (2004) Quick intraoperative parathyroid hormone assay: surgical adjunct to allow limited parathyroidectomy, improve success rate, and predict outcome. World J Surg 28(12):1287–1292PubMedCrossRefGoogle Scholar
  21. 21.
    Richards ML, Thompson GB, Farley DR, Grant CS (2008) Reoperative parathyroidectomy in 228 patients during the era of minimal-access surgery and intraoperative parathyroid hormone monitoring. Am J Surg 196(6):937–942 discussion 942–933PubMedCrossRefGoogle Scholar
  22. 22.
    Yen TW, Wang TS, Doffek KM, Krzywda EA, Wilson SD (2008) Reoperative parathyroidectomy: an algorithm for imaging and monitoring of intraoperative parathyroid hormone levels that results in a successful focused approach. Surgery 144(4):611–619 discussion 619–621PubMedCrossRefGoogle Scholar
  23. 23.
    Carter AB, Howanitz PJ (2003) Intraoperative testing for parathyroid hormone: a comprehensive review of the use of the assay and the relevant literature. Arch Pathol Lab Med 127(11):1424–1442PubMedGoogle Scholar
  24. 24.
    Bieglmayer C, Prager G, Niederle B (2002) Kinetic analyses of parathyroid hormone clearance as measured by three rapid immunoassays during parathyroidectomy. Clin Chem 48(10):1731–1738PubMedGoogle Scholar
  25. 25.
    Woodrum DT, Saunders BD, England BG, Burney RE, Doherty GM, Gauger PG (2004) The influence of sample site on intraoperative PTH monitoring during parathyroidectomy. Surgery 136(6):1169–1175PubMedCrossRefGoogle Scholar
  26. 26.
    De Vos tot Nederveen Cappel R, Bouvy N, de Herder W, de Rijke Y, van Toor H, Bonjer J (2007) Novel criteria for parathyroid hormone levels in parathyroid hormone-guided parathyroid surgery. Arch Pathol Lab Med 131(12):1800–1804Google Scholar
  27. 27.
    Miller BS, England BG, Nehs M, Burney RE, Doherty GM, Gauger PG (2006) Interpretation of intraoperative parathyroid hormone monitoring in patients with baseline parathyroid hormone levels of <100 pg/mL. Surgery 140(6):883–889 discussion 889–890PubMedCrossRefGoogle Scholar
  28. 28.
    Agarwal G, Barakate MS, Robinson B, Wilkinson M, Barraclough B, Reeve TS, Delbridge LW (2001) Intraoperative quick parathyroid hormone versus same-day parathyroid hormone testing for minimally invasive parathyroidectomy: a cost-effectiveness study. Surgery 130(6):963–970PubMedCrossRefGoogle Scholar
  29. 29.
    Gauger PG, Mullan MH, Thompson NW, Doherty GM, Matz KA, England BG (2004) An alternative analysis of intraoperative parathyroid hormone data may improve the ability to detect multiglandular disease. Arch Surg 139(2):164–169PubMedCrossRefGoogle Scholar
  30. 30.
    Karakousis GC, Han D, Kelz RR, Nemani D, Karamacharya J, Roses R, Gimotty PA, Fraker DL (2007) Interpretation of intra-operative PTH changes in patients with multi-glandular primary hyperparathyroidism (pHPT). Surgery 142(6):845–850 discussion 850 and 841–842PubMedCrossRefGoogle Scholar
  31. 31.
    Riss P, Kaczirek K, Heinz G, Bieglmayer C, Niederle B (2007) A “defined baseline” in PTH monitoring increases surgical success in patients with multiple gland disease. Surgery 142(3):398–404PubMedCrossRefGoogle Scholar
  32. 32.
    Siperstein A, Berber E, Barbosa GF, Tsinberg M, Greene AB, Mitchell J, Milas M (2008) Predicting the success of limited exploration for primary hyperparathyroidism using ultrasound, sestamibi, and intraoperative parathyroid hormone: analysis of 1158 cases. Ann Surg 248(3):420–428PubMedGoogle Scholar
  33. 33.
    Carneiro DM, Solorzano CC, Nader MC, Ramirez M, Irvin GL 3rd (2003) Comparison of intraoperative iPTH assay (QPTH) criteria in guiding parathyroidectomy: which criterion is the most accurate? Surgery 134(6):973–979 discussion 979–981PubMedCrossRefGoogle Scholar
  34. 34.
    Inabnet WB (2004) Intraoperative parathyroid hormone monitoring. World J Surg 28(12):1212–1215PubMedCrossRefGoogle Scholar
  35. 35.
    Rolighed L, Heickendorff L, Hessov I, Garne JP, Rodt SA, Christiansen P (2004) Primary hyperparathyroidism: intraoperative PTH-measurements. Scand J Surg 93(1):43–47PubMedGoogle Scholar
  36. 36.
    Di Stasio E, Carrozza C, Pio Lombardi C, Raffaelli M, Traini E, Bellantone R, Zuppi C (2007) Parathyroidectomy monitored by intra-operative PTH: the relevance of the 20 min end-point. Clin Biochem 40(9–10):595–603PubMedGoogle Scholar
  37. 37.
    Emmolo I, Corso HD, Borretta G, Visconti G, Piovesan A, Cesario F, Borghi F (2005) Unexpected results using rapid intraoperative parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism. World J Surg 29(6):785–788PubMedCrossRefGoogle Scholar
  38. 38.
    Phillips IJ, Kurzawinski TR, Honour JW (2005) Potential pitfalls in intraoperative parathyroid hormone measurements during parathyroid surgery. Ann Clin Biochem 42(Pt 6):453–458PubMedCrossRefGoogle Scholar
  39. 39.
    Mozzon M, Mortier PE, Jacob PM, Soudan B, Boersma AA, Proye CA (2004) Surgical management of primary hyperparathyroidism: the case for giving up quick intraoperative PTH assay in favor of routine PTH measurement the morning after. Ann Surg 240(6):949–953 discussion 953–944PubMedCrossRefGoogle Scholar
  40. 40.
    Lombardi CP, Raffaelli M, Traini E, Di Stasio E, Carrozza C, De Crea C, Zuppi C, Bellantone R (2008) Intraoperative PTH monitoring during parathyroidectomy: the need for stricter criteria to detect multiglandular disease. Langenbecks Arch Surg 393(5):639–645PubMedCrossRefGoogle Scholar
  41. 41.
    Weber KJ, Misra S, Lee JK, Wilhelm SW, DeCresce R, Prinz RA (2004) Intraoperative PTH monitoring in parathyroid hyperplasia requires stricter criteria for success. Surgery 136(6):1154–1159PubMedCrossRefGoogle Scholar
  42. 42.
    McGill J, Sturgeon C, Kaplan SP, Chiu B, Kaplan EL, Angelos P (2008) How does the operative strategy for primary hyperparathyroidism impact the findings and cure rate? A comparison of 800 parathyroidectomies. J Am Coll Surg 207(2):246–249PubMedCrossRefGoogle Scholar
  43. 43.
    Gauger PG, Agarwal G, England BG, Delbridge LW, Matz KA, Wilkinson M, Robinson BG, Thompson NW (2001) Intraoperative parathyroid hormone monitoring fails to detect double parathyroid adenomas: a 2-institution experience. Surgery 130(6):1005–1010PubMedCrossRefGoogle Scholar
  44. 44.
    Clerici T, Brandle M, Lange J, Doherty GM, Gauger PG (2004) Impact of intraoperative parathyroid hormone monitoring on the prediction of multiglandular parathyroid disease. World J Surg 28(2):187–192PubMedCrossRefGoogle Scholar
  45. 45.
    Carneiro DM, Irvin GL 3rd (2000) Late parathyroid function after successful parathyroidectomy guided by intraoperative hormone assay (QPTH) compared with the standard bilateral neck exploration. Surgery 128(6):925–929 discussion 935–926PubMedCrossRefGoogle Scholar
  46. 46.
    Westerdahl J, Bergenfelz A (2006) Parathyroid surgical failures with sufficient decline of intraoperative parathyroid hormone levels: unobserved multiple endocrine neoplasia as an explanation. Arch Surg 141(6):589–594PubMedCrossRefGoogle Scholar
  47. 47.
    Norman J, Denham D (1998) Minimally invasive radioguided parathyroidectomy in the reoperative neck. Surgery 124(6):1088–1092 discussion 1092–1083PubMedCrossRefGoogle Scholar
  48. 48.
    Chen H, Mack E, Starling JR (2005) A comprehensive evaluation of perioperative adjuncts during minimally invasive parathyroidectomy: which is most reliable? Ann Surg 242(3):375–380 discussion 380–373PubMedGoogle Scholar
  49. 49.
    Rubello D, Casara D, Giannini S, Piotto A, De Carlo E, Muzzio PC, Pelizzo MR (2003) Importance of radio-guided minimally invasive parathyroidectomy using hand-held gamma probe and low (99m)Tc-MIBI dose. Technical considerations and long-term clinical results. Q J Nucl Med 47(2):129–138PubMedGoogle Scholar
  50. 50.
    Mariani G, Gulec SA, Rubello D, Boni G, Puccini M, Pelizzo MR, Manca G, Casara D, Sotti G, Erba P, Volterrani D, Giuliano AE (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44(9):1443–1458PubMedGoogle Scholar
  51. 51.
    Inabnet WB 3rd, Kim CK, Haber RS, Lopchinsky RA (2002) Radioguidance is not necessary during parathyroidectomy. Arch Surg 137(8):967–970PubMedCrossRefGoogle Scholar
  52. 52.
    Chen H, Mack E, Starling JR (2003) Radioguided parathyroidectomy is equally effective for both adenomatous and hyperplastic glands. Ann Surg 238(3):332–337 discussion 337–338PubMedGoogle Scholar
  53. 53.
    Goldstein RE, Billheimer D, Martin WH, Richards K (2003) Sestamibi scanning and minimally invasive radioguided parathyroidectomy without intraoperative parathyroid hormone measurement. Ann Surg 237(5):722–730 discussion 730–721PubMedCrossRefGoogle Scholar
  54. 54.
    Jaskowiak NT, Sugg SL, Helke J, Koka MR, Kaplan EL (2002) Pitfalls of intraoperative quick parathyroid hormone monitoring and gamma probe localization in surgery for primary hyperparathyroidism. Arch Surg 137(6):659–668 discussion 668–659PubMedCrossRefGoogle Scholar
  55. 55.
    Schachter PP, Issa N, Shimonov M, Czerniak A, Lorberboym M (2004) Early, postinjection MIBI-SPECT as the only preoperative localizing study for minimally invasive parathyroidectomy. Arch Surg 139(4):433–437PubMedCrossRefGoogle Scholar
  56. 56.
    Casara D, Rubello D, Pelizzo MR, Shapiro B (2001) Clinical role of 99mTcO4/MIBI scan, ultrasound and intra-operative gamma probe in the performance of unilateral and minimally invasive surgery in primary hyperparathyroidism. Eur J Nucl Med 28(9):1351–1359PubMedCrossRefGoogle Scholar
  57. 57.
    Burkey SH, Van Heerden JA, Farley DR, Thompson GB, Grant CS, Curlee KJ (2002) Will directed parathyroidectomy utilizing the gamma probe or intraoperative parathyroid hormone assay replace bilateral cervical exploration as the preferred operation for primary hyperparathyroidism? World J Surg 26(8):914–920PubMedCrossRefGoogle Scholar
  58. 58.
    McGreal G, Winter DC, Sookhai S, Evoy D, Ryan M, O’Sullivan GC, Redmond HP (2001) Minimally invasive, radioguided surgery for primary hyperparathyroidism. Ann Surg Oncol 8(10):856–860PubMedCrossRefGoogle Scholar
  59. 59.
    Norman J, Chheda H (1997) Minimally invasive parathyroidectomy facilitated by intraoperative nuclear mapping. Surgery 122(6):998–1003 discussion 1003–1004PubMedCrossRefGoogle Scholar
  60. 60.
    Farley DR (2004) Technetium-99m 2-methoxyisobutyl isonitrile-scintigraphy: preoperative and intraoperative guidance for primary hyperparathyroidism. World J Surg 28(12):1207–1211PubMedCrossRefGoogle Scholar
  61. 61.
    Bozkurt MF, Ugur O, Hamaloglu E, Sayek I, Gulec SA (2003) Optimization of the gamma probe-guided parathyroidectomy. Am Surg 69(8):720–725PubMedGoogle Scholar
  62. 62.
    Friedman M, Gurpinar B, Schalch P, Joseph NJ (2007) Guidelines for radioguided parathyroid surgery. Arch Otolaryngol Head Neck Surg 133(12):1235–1239PubMedCrossRefGoogle Scholar
  63. 63.
    Ugur O, Bozkurt MF, Hamaloglu E, Sokmensuer C, Etikan I, Ugur Y, Sayek I, Gulec SA (2004) Clinicopathologic and radiopharmacokinetic factors affecting gamma probe-guided parathyroidectomy. Arch Surg 139(11):1175–1179PubMedCrossRefGoogle Scholar
  64. 64.
    Caudle AS, Brier SE, Calvo BF, Kim HJ, Meyers MO, Ollila DW (2006) Experienced radio-guided surgery teams can successfully perform minimally invasive radio-guided parathyroidectomy without intraoperative parathyroid hormone assays. Am Surg 72(9):785–789 discussion 790PubMedGoogle Scholar
  65. 65.
    Murphy C, Norman J (1999) The 20% rule: a simple, instantaneous radioactivity measurement defines cure and allows elimination of frozen sections and hormone assays during parathyroidectomy. Surgery 126(6):1023–1028 discussion 1028–1029PubMedCrossRefGoogle Scholar
  66. 66.
    Hanif F, Coffey JC, Romics L Jr, O’Sullivan K, Aftab F, Redmond HP (2006) Rapid intraoperative parathyroid hormone assay—more than just a comfort measure. World J Surg 30(2):156–161PubMedCrossRefGoogle Scholar
  67. 67.
    Rubello D, Piotto A, Casara D, Muzzio PC, Shapiro B, Pelizzo MR (2003) Role of gamma probes in performing minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: optimization of preoperative and intraoperative procedures. Eur J Endocrinol 149(1):7–15PubMedCrossRefGoogle Scholar
  68. 68.
    Norman J, Politz D (2008) Measuring individual parathyroid gland hormone production in real-time during radioguided parathyroidectomy. Experience in over 8,000 operations. Minerva Endocrinol 33(3):147–157PubMedGoogle Scholar
  69. 69.
    Rubello D, Mariani G, Pelizzo MR (2007) Minimally invasive radio-guided parathyroidectomy on a group of 452 primary hyperparathyroid patients: refinement of preoperative imaging and intraoperative procedure. Nuklearmedizin 46(3):85–92PubMedGoogle Scholar
  70. 70.
    Perrier ND, Ituarte PH, Morita E, Hamill T, Gielow R, Duh QY, Clark OH (2002) Parathyroid surgery: separating promise from reality. J Clin Endocrinol Metab 87(3):1024–1029PubMedCrossRefGoogle Scholar
  71. 71.
    Fahy BN, Bold RJ, Beckett L, Schneider PD (2002) Modern parathyroid surgery: a cost-benefit analysis of localizing strategies. Arch Surg 137(8):917–922 discussion 922–913PubMedCrossRefGoogle Scholar
  72. 72.
    Geelhoed GW, Silverberg SG (1984) Intraoperative imprints for the identification of parathyroid tissue. Surgery 96(6):1124–1131PubMedGoogle Scholar
  73. 73.
    Shidham VB, Asma Z, Rao RN, Chavan A, Machhi J, Almagro U, Komorowski RA (2002) Intraoperative cytology increases the diagnostic accuracy of frozen sections for the confirmation of various tissues in the parathyroid region. Am J Clin Pathol 118(6):895–902PubMedCrossRefGoogle Scholar
  74. 74.
    Hosking SW, Jones H, du Boulay CE, McGinn FP (1993) Surgery for parathyroid adenoma and hyperplasia: relationship of histology to outcome. Head Neck 15(1):24–28PubMedCrossRefGoogle Scholar
  75. 75.
    Saxe AW, Baier R, Tesluk H, Toreson W (1985) The role of the pathologist in the surgical treatment of hyperparathyroidism. Surg Gynecol Obstet 161(2):101–105PubMedGoogle Scholar
  76. 76.
    Westra WH, Pritchett DD, Udelsman R (1998) Intraoperative confirmation of parathyroid tissue during parathyroid exploration: a retrospective evaluation of the frozen section. Am J Surg Pathol 22(5):538–544PubMedCrossRefGoogle Scholar
  77. 77.
    Anton RC, Wheeler TM (2005) Frozen section of thyroid and parathyroid specimens. Arch Pathol Lab Med 129(12):1575–1584PubMedGoogle Scholar
  78. 78.
    Baloch ZW, LiVolsi VA (2002) Intraoperative assessment of thyroid and parathyroid lesions. Semin Diagn Pathol 19(4):219–226PubMedGoogle Scholar
  79. 79.
    Boggs JE, Irvin GL 3rd, Carneiro DM, Molinari AS (1999) The evolution of parathyroidectomy failures. Surgery 126(6):998–1002 discussion 1002–1003PubMedGoogle Scholar
  80. 80.
    Levin KE, Clark OH (1989) The reasons for failure in parathyroid operations. Arch Surg 124(8):911–914 discussion 914–915PubMedGoogle Scholar
  81. 81.
    Robertson GS, Iqbal SJ, Bolia A, Bell PR, Veitch PS (1992) Intraoperative parathyroid hormone estimation: a valuable adjunct to parathyroid surgery. Ann R Coll Surg Engl 74(1):19–22PubMedGoogle Scholar
  82. 82.
    Roslyn JJ, Mulder DG, Gordon HE (1981) Persistent and recurrent hyperparathyroidism. Am J Surg 142(1):21–25PubMedCrossRefGoogle Scholar
  83. 83.
    Elliott DD, Monroe DP, Perrier ND (2006) Parathyroid histopathology: is it of any value today? J Am Coll Surg 203(5):758–765PubMedCrossRefGoogle Scholar
  84. 84.
    Perrier ND, Ituarte P, Kikuchi S, Siperstein AE, Duh QY, Clark OH, Gielow R, Hamill T (2000) Intraoperative parathyroid aspiration and parathyroid hormone assay as an alternative to frozen section for tissue identification. World J Surg 24(11):1319–1322PubMedCrossRefGoogle Scholar
  85. 85.
    Chan RK, Ibrahim SI, Pil P, Tanasijevic M, Moore FD (2005) Validation of a method to replace frozen section during parathyroid exploration by using the rapid parathyroid hormone assay on parathyroid aspirates. Arch Surg 140(4):371–373PubMedCrossRefGoogle Scholar
  86. 86.
    Lo CY, Chan WF, Leung P, Luk JM (2005) Applicability of tissue aspirate for quick parathyroid hormone assay to confirm parathyroid tissue identity during parathyroidectomy for primary hyperparathyroidism. Arch Surg 140(2):146–149 discussion 150PubMedCrossRefGoogle Scholar
  87. 87.
    Conrad DN, Olson JE, Hartwig HM, Mack E, Chen H (2006) A prospective evaluation of novel methods to intraoperatively distinguish parathyroid tissue utilizing a parathyroid hormone assay. J Surg Res 133(1):38–41PubMedCrossRefGoogle Scholar
  88. 88.
    Dewan AK, Kapadia SB, Hollenbeak CS, Stack BC Jr (2005) Is routine frozen section necessary for parathyroid surgery? Otolaryngol Head Neck Surg 133(6):857–862PubMedCrossRefGoogle Scholar
  89. 89.
    Dudley NE (1971) Methylene blue for rapid identification of the parathyroids. Br Med J 3(5776):680–681PubMedCrossRefGoogle Scholar
  90. 90.
    Bambach CP, Reeve TS (1978) Parathyroid identification by methylene blue infusion. Aust N Z J Surg 48(3):314–317PubMedCrossRefGoogle Scholar
  91. 91.
    Devine RM, van Heerden JA, Grant CS, Muir JJ (1983) The role of methylene blue infusion in the management of persistent or recurrent hyperparathyroidism. Surgery 94(6):916–918PubMedGoogle Scholar
  92. 92.
    Gordon DL, Airan MC, Thomas W, Seidman LH (1975) Parathyroid identification by methylene blue infusion. Br J Surg 62(9):747–749PubMedCrossRefGoogle Scholar
  93. 93.
    Kuriloff DB, Sanborn KV (2004) Rapid intraoperative localization of parathyroid glands utilizing methylene blue infusion. Otolaryngol Head Neck Surg 131(5):616–622PubMedCrossRefGoogle Scholar
  94. 94.
    Orloff LA (2001) Methylene blue and sestamibi: complementary tools for localizing parathyroids. Laryngoscope 111(11 Pt 1):1901–1904PubMedCrossRefGoogle Scholar
  95. 95.
    Schell SR, Dudley NE (2003) Clinical outcomes and fiscal consequences of bilateral neck exploration for primary idiopathic hyperparathyroidism without preoperative radionuclide imaging or minimally invasive techniques. Surgery 133(1):32–39PubMedCrossRefGoogle Scholar
  96. 96.
    Sherlock DJ, Holl-Allen RT (1984) Intravital methylene blue staining of parathyroid glands and tumours. Ann R Coll Surg Engl 66(6):396–398PubMedGoogle Scholar
  97. 97.
    Sinha SN, Subramaniam P (1996) Initial parathyroid exploration: current trends in Australia. Aust N Z J Surg 66(5):279–281PubMedCrossRefGoogle Scholar
  98. 98.
    Takei H, Iino Y, Endo K, Horiguchi J, Maemura M, Koibuchi Y, Horii Y, Yokoe T, Ishida T, Oyama T, Morishita Y (1999) The efficacy of technetium-99m-MIBI scan and intraoperative methylene blue staining for the localization of abnormal parathyroid glands. Surg Today 29(4):307–312PubMedCrossRefGoogle Scholar
  99. 99.
    Traynor S, Adams JR, Andersen P, Everts E, Cohen J (1998) Appropriate timing and velocity of infusion for the selective staining of parathyroid glands by intravenous methylene blue. Am J Surg 176(1):15–17PubMedCrossRefGoogle Scholar
  100. 100.
    Wheeler MH, Wade JS (1982) Intraoperative identification of parathyroid glands: appraisal of methylene blue staining. Am J Surg 143(6):713–716PubMedCrossRefGoogle Scholar
  101. 101.
    Cox RJ, Moore DB, Wolfman EF Jr (1979) Localization of the parathyroid glands by intraoperative methylene blue staining. Surg Gynecol Obstet 148(5):769–770PubMedGoogle Scholar
  102. 102.
    Gavilan J, Gavilan C, Tomas MD (1986) Methylene blue infusion for intraoperative identification of the parathyroid glands. Laryngoscope 96(12):1389–1390PubMedGoogle Scholar
  103. 103.
    Derom AF, Wallaert PC, Janzing HM, Derom FE (1993) Intraoperative identification of parathyroid glands with methylene blue infusion. Am J Surg 165(3):380–382PubMedCrossRefGoogle Scholar
  104. 104.
    Bland KI, Tidwell S, von Fraunhofer JA, Morris RR, McCoy MT, Wathen RL (1985) Intraoperative localization of parathyroid glands using methylthionine chloride/tetramethylthionine chloride in secondary hyperparathyroidism. Surg Gynecol Obstet 160(1):42–48PubMedGoogle Scholar
  105. 105.
    Flynn MB, Bumpous JM, Schill K, McMasters KM (2000) Minimally invasive radioguided parathyroidectomy. J Am Coll Surg 191(1):24–31PubMedCrossRefGoogle Scholar
  106. 106.
    Grady JA, Bumpous JM, Fleming MM, Flynn MB, Turbiner E, Lentsch EJ, Ziegler CH (2006) Advantages of a targeted approach in minimally invasive radioguided parathyroidectomy surgery for primary hyperparathyroidism. Laryngoscope 116(3):431–435PubMedCrossRefGoogle Scholar
  107. 107.
    Han N, Bumpous JM, Goldstein RE, Fleming MM, Flynn MB (2007) Intra-operative parathyroid identification using methylene blue in parathyroid surgery. Am Surg 73(8):820–823PubMedGoogle Scholar
  108. 108.
    Martin RC 2nd, Greenwell D, Flynn MB (2000) Initial neck exploration for untreated hyperparathyroidism. Am Surg 66(3):269–272PubMedGoogle Scholar
  109. 109.
    Robert J, Delay D, Buhler L, Garcia A, Spilipoulos A (1998) Methylene blue in surgery of primary hyperparathyroidism. Ann Endocrinol (Paris) 59(1):23–26Google Scholar
  110. 110.
    Ahmed TS (2006) Methylene blue toxicity following infusion to localize parathyroid adenoma. J Laryngol Otol 120(8):708 author reply 708–709PubMedGoogle Scholar
  111. 111.
    Bach KK, Lindsay FW, Berg LS, Howard RS (2004) Prolonged postoperative disorientation after methylene blue infusion during parathyroidectomy. Anesth Analg 99(5):1573–1574 table of contentsPubMedCrossRefGoogle Scholar
  112. 112.
    Khan MA, North AP, Chadwick DR (2007) Prolonged postoperative altered mental status after methylene blue infusion during parathyroidectomy: a case report and review of the literature. Ann R Coll Surg Engl 89(2):W9–W11PubMedCrossRefGoogle Scholar
  113. 113.
    Majithia A, Stearns MP (2006) Methylene blue toxicity following infusion to localize parathyroid adenoma. J Laryngol Otol 120(2):138–140PubMedCrossRefGoogle Scholar
  114. 114.
    Mathew S, Linhartova L, Raghuraman G (2006) Hyperpyrexia and prolonged postoperative disorientation following methylene blue infusion during parathyroidectomy. Anaesthesia 61(6):580–583PubMedCrossRefGoogle Scholar
  115. 115.
    Patel AS, Singh-Ranger D, Lowery KA, Crinnion JN (2006) Adverse neurologic effect of methylene blue used during parathyroidectomy. Head Neck 28(6):567–568PubMedCrossRefGoogle Scholar
  116. 116.
    Vutskits L, Briner A, Klauser P, Gascon E, Dayer AG, Kiss JZ, Muller D, Licker MJ, Morel DR (2008) Adverse effects of methylene blue on the central nervous system. Anesthesiology 108(4):684–692PubMedCrossRefGoogle Scholar
  117. 117.
    Licker M, Diaper J, Robert J, Ellenberger C (2008) Effects of methylene blue on propofol requirement during anaesthesia induction and surgery. Anaesthesia 63(4):352–357PubMedCrossRefGoogle Scholar
  118. 118.
    Kartha SS, Chacko CE, Bumpous JM, Fleming M, Lentsch EJ, Flynn MB (2006) Toxic metabolic encephalopathy after parathyroidectomy with methylene blue localization. Otolaryngol Head Neck Surg 135(5):765–768PubMedCrossRefGoogle Scholar
  119. 119.
    Sweet G, Standiford SB (2007) Methylene-blue-associated encephalopathy. J Am Coll Surg 204(3):454–458PubMedCrossRefGoogle Scholar
  120. 120.
    Martindale SJ, Stedeford JC (2003) Neurological sequelae following methylene blue injection for parathyroidectomy. Anaesthesia 58(10):1041–1042PubMedCrossRefGoogle Scholar
  121. 121.
    Shanmugam G (2005) Vasoplegic syndrome—the role of methylene blue. Eur J Cardiothorac Surg 28(5):705–710PubMedCrossRefGoogle Scholar
  122. 122.
    Masaki E, Kondo I (1999) Methylene blue, a soluble guanylyl cyclase inhibitor, reduces the sevoflurane minimum alveolar anesthetic concentration and decreases the brain cyclic guanosine monophosphate content in rats. Anesth Analg 89(2):484–489PubMedCrossRefGoogle Scholar
  123. 123.
    Evgenov OV, Sveinbjornsson B, Bjertnaes LJ (2001) Continuously infused methylene blue modulates the early cardiopulmonary response to endotoxin in awake sheep. Acta Anaesthesiol Scand 45(10):1246–1254PubMedCrossRefGoogle Scholar
  124. 124.
    Allendorf J, DiGorgi M, Spanknebel K, Inabnet W, Chabot J, Logerfo P (2007) 1112 consecutive bilateral neck explorations for primary hyperparathyroidism. World J Surg 31(11):2075–2080PubMedCrossRefGoogle Scholar
  125. 125.
    Udelsman R (2002) Six hundred fifty-six consecutive explorations for primary hyperparathyroidism. Ann Surg 235(5):665–670 discussion 670–662PubMedCrossRefGoogle Scholar
  126. 126.
    Bergenfelz A, Jansson S, Martensson H, Reihner E, Wallin G, Kristoffersson A, Lausen I (2007) Scandinavian Quality Register for Thyroid and Parathyroid Surgery: audit of surgery for primary hyperparathyroidism. Langenbecks Arch Surg 392(4):445–451PubMedCrossRefGoogle Scholar
  127. 127.
    Barwell J, Lytle J, Page R, Wilkins D (1997) The NIM-2 nerve integrity monitor in thyroid and parathyroid surgery. Br J Surg 84(6):854PubMedCrossRefGoogle Scholar
  128. 128.
    Brennan J, Moore EJ, Shuler KJ (2001) Prospective analysis of the efficacy of continuous intraoperative nerve monitoring during thyroidectomy, parathyroidectomy, and parotidectomy. Otolaryngol Head Neck Surg 124(5):537–543PubMedCrossRefGoogle Scholar
  129. 129.
    Marcus B, Edwards B, Yoo S, Byrne A, Gupta A, Kandrevas J, Bradford C, Chepeha DB, Teknos TN (2003) Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery: the University of Michigan experience. Laryngoscope 113(2):356–361PubMedCrossRefGoogle Scholar
  130. 130.
    Snyder SK, Hendricks JC (2005) Intraoperative neurophysiology testing of the recurrent laryngeal nerve: plaudits and pitfalls. Surgery 138(6):1183–1191 discussion 1191–1182PubMedCrossRefGoogle Scholar
  131. 131.
    Dralle H, Sekulla C, Haerting J, Timmermann W, Neumann HJ, Kruse E, Grond S, Muhlig HP, Richter C, Voss J, Thomusch O, Lippert H, Gastinger I, Brauckhoff M, Gimm O (2004) Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery 136(6):1310–1322PubMedCrossRefGoogle Scholar
  132. 132.
    Barczynski M, Konturek A, Cichon S (2009) Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 96(3):240–246PubMedCrossRefGoogle Scholar
  133. 133.
    Hermann M, Alk G, Roka R, Glaser K, Freissmuth M (2002) Laryngeal recurrent nerve injury in surgery for benign thyroid diseases: effect of nerve dissection and impact of individual surgeon in more than 27, 000 nerves at risk. Ann Surg 235(2):261–268PubMedCrossRefGoogle Scholar
  134. 134.
    Jatzko GR, Lisborg PH, Muller MG, Wette VM (1994) Recurrent nerve palsy after thyroid operations—principal nerve identification and a literature review. Surgery 115(2):139–144PubMedGoogle Scholar
  135. 135.
    Riddell VH (1956) Injury to recurrent laryngeal nerves during thyroidectomy; a comparison between the results of identification and non-identification in 1022 nerves exposed to risk. Lancet 271(6944):638–641PubMedCrossRefGoogle Scholar
  136. 136.
    Randolph G, Urken M (2003) Surgical management of primary hyperparathyroidism. In: Randolph G (ed) Surgery of the thyroid and parathyroid glands. Saunders, Philadelphia, pp 507–528Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Endocrine SurgeryRoyal Hallamshire HospitalSheffieldUK
  2. 2.Thoracic & Endocrine SurgeryUniversity Hospital of GenevaGenevaSwitzerland

Personalised recommendations