Cargando…

Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study

INTRODUCTION: An accurate differential diagnosis between single adenoma (SA) and multiglandular disease (MGD) remains difficult in Technetium-99m sestamibi scintigraphy (MIBI)-negative patients with primary hyperparathyroidism (PHPT). The aim of the present study was to evaluate the minimally invasi...

Descripción completa

Detalles Bibliográficos
Autores principales: Toriie, Sayoko, Sugimoto, Takeki, Hokimoto, Norihiro, Funakoshi, Taku, Ogawa, Maho, Oki, Toyokazu, Dabanaka, Ken, Namikawa, Tsutomu, Sakurai, Akihiro, Hanazaki, Kazuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802411/
https://www.ncbi.nlm.nih.gov/pubmed/27054033
http://dx.doi.org/10.1016/j.amsu.2016.03.003
_version_ 1782422714845233152
author Toriie, Sayoko
Sugimoto, Takeki
Hokimoto, Norihiro
Funakoshi, Taku
Ogawa, Maho
Oki, Toyokazu
Dabanaka, Ken
Namikawa, Tsutomu
Sakurai, Akihiro
Hanazaki, Kazuhiro
author_facet Toriie, Sayoko
Sugimoto, Takeki
Hokimoto, Norihiro
Funakoshi, Taku
Ogawa, Maho
Oki, Toyokazu
Dabanaka, Ken
Namikawa, Tsutomu
Sakurai, Akihiro
Hanazaki, Kazuhiro
author_sort Toriie, Sayoko
collection PubMed
description INTRODUCTION: An accurate differential diagnosis between single adenoma (SA) and multiglandular disease (MGD) remains difficult in Technetium-99m sestamibi scintigraphy (MIBI)-negative patients with primary hyperparathyroidism (PHPT). The aim of the present study was to evaluate the minimally invasive parathyroidectomy (MIP) in patients with PHPT. METHODS: Clinical records of 48 patients who underwent neck exploration between November 2002 and June 2012 in Kochi Medical School Hospital were reviewed retrospectively to identify candidates that underwent for MIP which was defined as the selective removal of a SA using less invasive surgery. RESULTS: The preoperative detection rate of lesions using ultrasonography, MIBI, computed tomography, and magnetic resonance imaging was 90%, 83%, 76%, and 55%, respectively. Although all 39 patients in the MIBI-positive group were diagnosed with an SA and subsequently underwent curative MIP, 3 patients in MIBI-negative group (n = 6) were MGD, who underwent neck exploration. Preoperative mean intact parathyroid hormone (419 pg/ml vs. 149 pg/ml; P < 0.01) and alkaline phosphatase levels (746 U/l vs. 277 U/l; P < 0.01) were significantly higher in the SA than MGD group. CONCLUSIONS: In MIBI-negative patients with indications for surgery, MIP should not be carried out without a clear localization of SA, or in MGD.
format Online
Article
Text
id pubmed-4802411
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-48024112016-04-06 Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study Toriie, Sayoko Sugimoto, Takeki Hokimoto, Norihiro Funakoshi, Taku Ogawa, Maho Oki, Toyokazu Dabanaka, Ken Namikawa, Tsutomu Sakurai, Akihiro Hanazaki, Kazuhiro Ann Med Surg (Lond) Original Research INTRODUCTION: An accurate differential diagnosis between single adenoma (SA) and multiglandular disease (MGD) remains difficult in Technetium-99m sestamibi scintigraphy (MIBI)-negative patients with primary hyperparathyroidism (PHPT). The aim of the present study was to evaluate the minimally invasive parathyroidectomy (MIP) in patients with PHPT. METHODS: Clinical records of 48 patients who underwent neck exploration between November 2002 and June 2012 in Kochi Medical School Hospital were reviewed retrospectively to identify candidates that underwent for MIP which was defined as the selective removal of a SA using less invasive surgery. RESULTS: The preoperative detection rate of lesions using ultrasonography, MIBI, computed tomography, and magnetic resonance imaging was 90%, 83%, 76%, and 55%, respectively. Although all 39 patients in the MIBI-positive group were diagnosed with an SA and subsequently underwent curative MIP, 3 patients in MIBI-negative group (n = 6) were MGD, who underwent neck exploration. Preoperative mean intact parathyroid hormone (419 pg/ml vs. 149 pg/ml; P < 0.01) and alkaline phosphatase levels (746 U/l vs. 277 U/l; P < 0.01) were significantly higher in the SA than MGD group. CONCLUSIONS: In MIBI-negative patients with indications for surgery, MIP should not be carried out without a clear localization of SA, or in MGD. Elsevier 2016-03-10 /pmc/articles/PMC4802411/ /pubmed/27054033 http://dx.doi.org/10.1016/j.amsu.2016.03.003 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Toriie, Sayoko
Sugimoto, Takeki
Hokimoto, Norihiro
Funakoshi, Taku
Ogawa, Maho
Oki, Toyokazu
Dabanaka, Ken
Namikawa, Tsutomu
Sakurai, Akihiro
Hanazaki, Kazuhiro
Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study
title Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study
title_full Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study
title_fullStr Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study
title_full_unstemmed Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study
title_short Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study
title_sort evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: a retrospective cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802411/
https://www.ncbi.nlm.nih.gov/pubmed/27054033
http://dx.doi.org/10.1016/j.amsu.2016.03.003
work_keys_str_mv AT toriiesayoko evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT sugimototakeki evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT hokimotonorihiro evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT funakoshitaku evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT ogawamaho evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT okitoyokazu evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT dabanakaken evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT namikawatsutomu evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT sakuraiakihiro evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy
AT hanazakikazuhiro evaluationoftheminimallyinvasiveparathyroidectomyinpatientswithprimaryhyperparathyroidismaretrospectivecohortstudy