Minimally Invasive Parathyroidectomy Using Surgical Sonography

Sadik, Karim W.; Kell, Malcolm R.; Gorey, T. F.

doi:10.7150/ijms.8.283

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…A common method is preoperative marking using US preoperatively or intraoperatively. 6 This is a cheap, noninvasive, and highly sensitive technique in experienced hands. A different localization method has been the use of 99m Tc.…”

Section: Discussionmentioning

confidence: 99%

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Iodine 125 Seed for Localization in Primary Hyperparathyroidism

et al. 2016

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Background Preoperative localization of the parathyroid gland prior to a minimally invasive parathyroidectomy (MIP) is important because of varying locations of the parathyroid gland. Several methods have been described to localize the affected gland. One novel technique is the use of an iodine 125 (I-125) seed as a marker. The aim of this study is to evaluate the feasibility of using an I-125 seed in localizing the diseased parathyroid gland prior to MIP. Materials and methods This is a pilot study of 10 patients performed in the Amphia Hospital, the Netherlands. Patients in whom primary hyperparathyroidism (PHPT) was diagnosed in combination with 1 enlarged parathyroid gland on ultrasound (US) and scintigraphy and who were eligible for MIP were included in this study. These patients underwent a preoperative US-guided I-125 seed placement in the affected parathyroid gland. The main study parameters were the feasibility of the placement, intraoperative localization of the diseased gland and complications. Results A total of 10 patients were included. The US-guided I-125 placement in the affected parathyroid gland was technically feasible in the majority of cases. Because of the anatomical location of the gland, the placement was difficult in 2 patients, resulting in suboptimal position and possible misplacement of the marker. MIP was uncomplicated in most cases. Complications during surgery were mainly intraoperative bleeding. Conclusions The use of an I-125 seed for preoperative localization in PHPT is a relatively safe technique in parathyroid surgery. More research is needed to compare this technique with other preoperative localization techniques.

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Section: Discussionmentioning

confidence: 99%

“…This is most often done by US. 6,7 Another localization technique that is used is with a blue dye (methylene blue). 8 Lack of preoperative localization increases the risk that the gland cannot be identified during surgery, requiring a reoperation or even a conventional neck exploration with even more risks and an increased morbidity.…”

Section: Introductionmentioning

confidence: 99%