Is Routine Frozen Section Necessary for Parathyroid Surgery?

Dewan, Anil; Kapadia, Silloo B.; Hollenbeak, Christopher S.; Stack, Brendan C.

doi:10.1016/j.otohns.2005.05.001

Cited by 39 publications

(16 citation statements)

References 12 publications

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“…Those surgeons who do not routinely use frozen sections or IOPTH sampling identify parathyroid glands on the basis of macroscopic criteria such as location in the neck, color, and consistency [88].…”

Section: Frozen Sectionmentioning

confidence: 99%

Intraoperative adjuncts in surgery for primary hyperparathyroidism

Harrison

Triponez

2009

Langenbecks Arch Surg

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Section: Frozen Sectionmentioning

confidence: 99%

Intraoperative adjuncts in surgery for primary hyperparathyroidism

Harrison

Triponez

2009

Langenbecks Arch Surg

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“…Despite the increase in surgical interventions for hyperparathyroidism, one qualifying influence on the number of parathyroid frozen sections has been the incorporation of rapid intraoperative parathyroid hormone levels (RI-PTH) into surgical management. In parathyroid adenoma surgeries that are coupled with RI-PTH, frozen section confirmation of the hypercellular gland may therefore no longer be necessary [15][16][17]. Guarda et al [16] studied 141 patients who underwent parathyroid surgery, 125 for adenoma, and 16 for secondary hyperplasia.…”

Section: Parathyroid Frozen Sectionsmentioning

confidence: 99%

Current practices in performing frozen sections for thyroid and parathyroid pathology

Osamura

Hunt

2008

Virchows Arch

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In this review article, current trends in thyroid and parathyroid frozen sections are discussed. In Japan and other countries, the numbers of thyroid frozen sections have been dramatically decreasing over the past decade. The decline in the number of thyroid frozen sections has been attributed to two major factors: highly diagnostic preoperative fine needle aspiration for papillary carcinomas, the most frequent type of thyroid cancers, and the acknowledgment in the literature of the disadvantageous frozen sections for follicular tumors. Several authors have argued that the frozen section of thyroid nodules should be limited only to cases that have a preoperative cytology diagnosis as "atypical" or "suspicious". In contrast, frozen sections for parathyroid glands have been increasing in numbers. This increase is thought to be largely due to the high number of parathyroidectomies for secondary hyperplasia in dialysis patients. Frozen sections are usually performed to confirm the removal of parathyroid tissue for either cyropreservation or auto-transplantation. It is concluded that thyroid and parathyroid frozen section examination is restricted to selected situations.

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“…(5) Dewan et alconcluded that FS is not recommended for typical PT appearance: large (> 1 cm), tan-mahogany, soft, "fleshy" on the cut surface. They emphasize the situations that warrant the judicious use of FS: inexperienced PT surgeon, multiple gland disease, ectopic gland location, technically difficult primary surgeries and revision surgery [4]. (02) In the current study frozen section diagnosis was complemented by post-operative parathyroid levels.…”

mentioning

confidence: 93%