Minimally Invasive Parathyroidectomy Using Surgeon‐performed Ultrasound and Sestamibi

Abstract

SPU in the hands of an experienced surgeon in association with sestamibi is a reliable tool for the preoperative localization of parathyroid adenomas and facilitates a minimally invasive procedure.

The Accuracy of Ultrasound in the Pre-Operative Localisation of Parathyroid Lesions in Primary Hyperparathyroidism: A Review of the Literature

“…In all studies, diagnosis was confirmed by successful surgical removal of parathyroid pathology with or without post surgical follow up histology and blood assays. Five studies additionally confirmed surgical success with follow up assays (Bhansali et al 2006;Carlier et al 2008;Lo et al 2007;Prasannan et al 2007;Shaheen et al 2008), and three studies confirmed the nature of the excised lesion(s) with histology (Mihai et al 2006;Lo et al 2007;Carlier et al 2008). …”

“…All studies, except two, (Mihai et al 2009, Prasannan et al 2007) stated that the US was interpreted without knowledge of the results of the NM scan. While, this approach limits risk of contamination between the two localization studies and provides an independent assessment of the localization study's performance, it does not mirror usual clinical practice.…”

“…9 Was the execution of the reference standard described in sufficient detail to permit its replication? Prasannan et al (2007) who provided no information on the execution of the Tc 99m sestamibi scan, and Shaheen et al (2008) who provided no information on the experience or credentials of the operator(s). Whilst most studies used pre-operative or post-operative hormone assays, only three studies (Bhansali et al 2006;Prasannan et al 2007;Sugg et al 2004) provided clear cut-off values for normal or abnormal assays.…”

“…Six studies compared US and NM to surgical findings (Bhansali et al 2006;Carlier et al 2008, Lo et al 2007Prasannan et al 2007;Shaheen et al 2008;Sugg et al 2004). Mihai et al (2006) differed by not directly comparing US to surgical findings, instead comparing it to NM only, then comparing NM to surgical findings.…”

“…US was performed by experienced radiologists in two studies (Carlier et al 200;Lo et al 2007), experienced sonographers in two studies (Bhansali et al 2006;Sugg et al 2004), a parathyroid surgeon in one study (Prasannan et al 2007) and the operator was not specified by Mihai et al (2006) or Shaheen et al (2008). Two studies (Lo et al 2007;Shaheen et al 2008) indicated that multiple operators were involved in performing the ultrasound examinations in their studies.…”