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Annals of Surgical Oncology

, Volume 8, Issue 10, pp 856–860 | Cite as

Minimally Invasive, Radioguided Surgery for Primary Hyperparathyroidism

  • G. McGreal
  • D. C. Winter
  • S. Sookhai
  • D. Evoy
  • M. Ryan
  • G. C. O’Sullivan
  • H. P. RedmondEmail author
Article

Abstract

Background: Primary hyperparathyroidism affects 1 in 700 individuals in the United States. A single adenoma is responsible in over 85% of cases. Surgery remains the most effective treatment. This study was designed to assess the feasibility of minimally invasive radioguided parathyroidectomy MIRP with confirmation of excision by ex vivo radioactivity alone.

Methods: Seventy-five consecutive patients with primary hyperparathyroidism were prospectively studied. Following sestamibi scan, patients underwent unilateral neck exploration guided by a handheld gamma probe, which was also used to measure ex vivo radioactivity of excised tissue.

Results: The sestamibi scan was positive in 88% of the patients. A small incision mean, 3.2 ± 0.3 cm was sufficient. Ectopic gland sites were localized in five patients with positive scans and single adenomas. Mean operative time was 48 minutes range, 15–125 minutes, with shorter procedures after the initial 20 cases mean, 24 vs. 72 minutes; P < .01. Radioguided parathyroidectomy was successful in 97%, with a mean follow-up of 11 months range, 1–26 months. As noted previously, adenomatous parathyroid glands contained more than 20% of the background radioactivity.

Conclusions: MIRP is a feasible alternative to bilateral dissection with the advantages of guided dissection and rapid confirmation, and may become the procedure of choice for primary hyperparathyroidism.

Key Words

Hyperparathyroidism Minimally invasive parathyroidectomy Sestamibi 

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Copyright information

© The Society of Surgical Oncology, Inc. 2001

Authors and Affiliations

  • G. McGreal
    • 1
  • D. C. Winter
    • 1
  • S. Sookhai
    • 1
  • D. Evoy
    • 1
  • M. Ryan
    • 1
  • G. C. O’Sullivan
    • 1
  • H. P. Redmond
    • 1
    • 2
    Email author
  1. 1.Academic Department of Surgery and Department of Surgical OncologyNational University of Ireland, Cork, at Cork University Hospital, and Mercy HospitalCork
  2. 2.Academic Department of SurgeryCork University HospitalWilton, CorkIreland

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