| Advantages of a targeted approach in minimally invasive radioguided parathyroidectomy surgery for primary hyperparathyroidism. | |
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MedLine Citation:
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PMID: 16540904 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: In a large series of patients, we associated the need for preoperative parathyroid hormone (PTH) and calcium levels as a vital component in our approach to the radioguided minimally invasive parathyroidectomy (MIRP) procedure. Our objective was to determine whether these preoperative levels indeed complemented the procedure. Our study also included a postoperative assessment of excised gland volume and length of operation. STUDY DESIGN: This was a prospective cohort study. METHODS:: One hundred seventy-three patients with primary hyperparathyroidism enrolled in our radioguided MIRP protocol. Patients were divided into groups based on the results of sestamibi scans. Comparisons were made between these results and the assessed preoperative PTH and calcium levels and the postoperative excised gland volume and length of operation. RESULTS: PTH and calcium levels did not statistically relate with the likelihood of having a "positive," "equivocal," or "negative" sestamibi scan, but the volume of excised gland was significantly different among the three groups (P < .01). There was no significant difference between positive and equivocal scans (P = .40). Operative time was significantly different between positive and equivocal scans (P < .01), positive and negative scans (P < .01), and equivocal and negative scans (P < .01). CONCLUSIONS: Routine preoperative PTH and calcium levels are necessary for the biologic diagnosis of hyperparathyroidism, but they do not appear to relate to the outcome of a sestamibi scan and therefore do not complement the radioguided MIRP procedure. Because the size of the affected gland, however, did correlate with a positive sestamibi scan, we conclude that as the volume of the gland increases, so does the likelihood of a successfully chosen minimally invasive surgical approach. |
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Authors:
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Jennifer A Grady; Jeffrey M Bumpous; Muffin M Fleming; Michael B Flynn; Elliott Turbiner; Eric J Lentsch; Craig H Ziegler |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Laryngoscope Volume: 116 ISSN: 0023-852X ISO Abbreviation: Laryngoscope Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-03-16 Completed Date: 2006-04-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 431-5 Citation Subset: IM |
Affiliation:
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Division of Otolaryngology, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40202, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Follow-Up Studies Humans Hyperparathyroidism, Primary / radionuclide imaging, surgery* Intraoperative Period Male Middle Aged Parathyroidectomy / methods* Prospective Studies Radiopharmaceuticals / diagnostic use* Surgical Procedures, Minimally Invasive / methods* Technetium Tc 99m Sestamibi / diagnostic use* Tomography, Emission-Computed Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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