Impact of Localization Studies on Feasibility of Minimally Invasive Parathyroidectomy in an Endemic Goiter Region

Prager, Gerhard; Czerny, Christian; Ofluoglu, Sedat; Kurtaran, Amir; Passler, Christian; Kaczirek, Klaus; Scheuba, Christian; Niederle, Bruno

doi:10.1016/s1072-7515(02)01897-5

Cited by 50 publications

(62 citation statements)

References 22 publications

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“…reducing the sound wave, displacing adjacent structures by mass effect, overlapping acoustic shadows [33,34]. If USG is performed by a surgeon (adequately experienced of course), sensitivity and accuracy of such examination are 87% and 88% respectively [10].…”

Section: Szkolenie Podyplomowementioning

confidence: 99%

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Imaging diagnostics for primary hyperparathyroidism

Gawrychowski¹,

Buła²

2013

Endokrynologia Polska

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Primary hyperparathyroidism (PHP) is a benign condition characterised by malignant potential. Even in specialist wards, 5-10% of operations for PHP are unsuccessful. The main reasons seem to be ectopy of the parathyroid gland, numerous adenomas, multiglandular parathyroid hyperplasia, and intrathyroid location of the parathyroid. The last three decades have witnessed a rapid progression in imaging diagnostics.

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Section: Szkolenie Podyplomowementioning

confidence: 99%

“…In secondary parathyroidism, sensitivity of the examination is 60% and specificity 64%. If the lesions are connected with more than one parathyroid gland, false diagnoses cover nearly 30% of patients [34].…”

Section: Szkolenie Podyplomowementioning

confidence: 99%

Imaging diagnostics for primary hyperparathyroidism

Gawrychowski¹,

Buła²

2013

Endokrynologia Polska

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“…Obviously, such larger lesions would also lend themselves to a more detailed ultrasound analysis. Ultrasound, often combined with 99m Tc Sestamibi scintigraphy [8], is key in the attempt to localise the source of pHPT before surgery [9,10], guiding the focused surgical approach to a targeted lesion [11,12]. Ultrasound techniques have improved with the introduction of high-frequency, high-resolution imaging and colour Doppler for detailed analysis of vascular patterns [13,14].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound features of malignancy in the preoperative diagnosis of parathyroid cancer: a retrospective analysis of parathyroid tumours larger than 15 mm

et al. 2011

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“…Our group therefore introduced a minimally invasive surgical approach for PHPT since 1993, wherein only a localized area of the neck is explored according to the preoperative imaging evaluation, and the adenoma is resected without histological sampling from the other parathyroid glands (Xu et al, 2006). Several groups have recently reported that concomitant thyroid nodules are main hazard to minimally invasive procedures (Eigelberger and Clark, 2000;Prager et al, 2003). In our setting, open minimally invasive parathyroid exploration is favorable because additional resection of isolated ipsilateral thyroid nodules is possible.…”

Section: Authorsmentioning

confidence: 86%

Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease

Zheng

Wang

et al. 2007

J. Zhejiang Univ. - Sci. B

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Abstract:The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study. Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision (about 3 cm), while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter (32.7%), 2 thyroiditis (3.8%), 2 thyroid adenoma (3.8%) and 1 thyroid carcinoma (1.9%) coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultrasonography (US) and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography (CT) and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of associated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.

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Impact of Localization Studies on Feasibility of Minimally Invasive Parathyroidectomy in an Endemic Goiter Region

Cited by 50 publications

References 22 publications

Imaging diagnostics for primary hyperparathyroidism

Imaging diagnostics for primary hyperparathyroidism

Ultrasound features of malignancy in the preoperative diagnosis of parathyroid cancer: a retrospective analysis of parathyroid tumours larger than 15 mm

Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease

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