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Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings

Background. Reoperative parathyroid surgery for primary hyperparathyroidism can be challenging. Numerous preoperative localization techniques have been employed to facilitate a more focused surgical exploration. This paper describes a novel, minimally invasive, and highly successful method of parath...

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Autores principales: Winters, Ryan, Friedlander, Paul, Noureldine, Salem, Ekaidi, Ibrahim, Moroz, Krzysztof, Kandil, Emad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195344/
https://www.ncbi.nlm.nih.gov/pubmed/22091358
http://dx.doi.org/10.1155/2011/487076
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author Winters, Ryan
Friedlander, Paul
Noureldine, Salem
Ekaidi, Ibrahim
Moroz, Krzysztof
Kandil, Emad
author_facet Winters, Ryan
Friedlander, Paul
Noureldine, Salem
Ekaidi, Ibrahim
Moroz, Krzysztof
Kandil, Emad
author_sort Winters, Ryan
collection PubMed
description Background. Reoperative parathyroid surgery for primary hyperparathyroidism can be challenging. Numerous preoperative localization techniques have been employed to facilitate a more focused surgical exploration. This paper describes a novel, minimally invasive, and highly successful method of parathyroid localization. Methods. Patients with recurrent or persistent primary hyperparathyroidism underwent parathyroidectomy following CT scan or ultrasound-guided wire localization of the parathyroid. Accurate placement was confirmed by fine-needle aspiration with immunocytochemistry or PTH washout. The guide wire was left in situ to guide surgical excision of the gland. Curative resection was established by monitoring intact serum PTH levels after excision of the adenoma. Results. All ten patients underwent successful redo-targeted parathyroidectomy. Nine of the ten patients were discharged on the day of surgery. One patient was observed overnight due to transient postoperative hypocalcemia, which resolved with calcium supplementation. Conclusion. Placement of a localization wire via preoperative high-resolution ultrasound or CT can expedite reoperative parathyroid surgery. It allows identification of parathyroid adenoma via a minimally invasive approach, especially in cases where a sestamibi scan is inconclusive.
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spelling pubmed-31953442011-11-16 Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings Winters, Ryan Friedlander, Paul Noureldine, Salem Ekaidi, Ibrahim Moroz, Krzysztof Kandil, Emad Minim Invasive Surg Clinical Study Background. Reoperative parathyroid surgery for primary hyperparathyroidism can be challenging. Numerous preoperative localization techniques have been employed to facilitate a more focused surgical exploration. This paper describes a novel, minimally invasive, and highly successful method of parathyroid localization. Methods. Patients with recurrent or persistent primary hyperparathyroidism underwent parathyroidectomy following CT scan or ultrasound-guided wire localization of the parathyroid. Accurate placement was confirmed by fine-needle aspiration with immunocytochemistry or PTH washout. The guide wire was left in situ to guide surgical excision of the gland. Curative resection was established by monitoring intact serum PTH levels after excision of the adenoma. Results. All ten patients underwent successful redo-targeted parathyroidectomy. Nine of the ten patients were discharged on the day of surgery. One patient was observed overnight due to transient postoperative hypocalcemia, which resolved with calcium supplementation. Conclusion. Placement of a localization wire via preoperative high-resolution ultrasound or CT can expedite reoperative parathyroid surgery. It allows identification of parathyroid adenoma via a minimally invasive approach, especially in cases where a sestamibi scan is inconclusive. Hindawi Publishing Corporation 2011 2011-08-13 /pmc/articles/PMC3195344/ /pubmed/22091358 http://dx.doi.org/10.1155/2011/487076 Text en Copyright © 2011 Ryan Winters et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Winters, Ryan
Friedlander, Paul
Noureldine, Salem
Ekaidi, Ibrahim
Moroz, Krzysztof
Kandil, Emad
Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings
title Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings
title_full Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings
title_fullStr Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings
title_full_unstemmed Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings
title_short Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings
title_sort preoperative parathyroid needle localization: a minimally invasive novel technique in reoperative settings
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195344/
https://www.ncbi.nlm.nih.gov/pubmed/22091358
http://dx.doi.org/10.1155/2011/487076
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