Preoperative Localization and Radioguided Parathyroid Surgery

摘要: Clinical or subclinical hyperparathyroidism is one of the most common endocrine disorders. Excessive secretion parathyroid hormone frequently caused by an adenoma >or=1 gland. Unsuccessful surgery with persistent hyperparathyroidism, due to inadequate preoperative intraoperative localization, may be observed in about 10% patients. The conventional surgical approach bilateral neck exploration, whereas minimally invasive parathyroidectomy (MIP) has been made possible introduction (99m)Tc-sestamibi scintigraphy for localization adenomas. In MIP, incision small, dissection minimal, postoperative pain less, and hospital stay shorter. Localization imaging techniques include ultrasonography, CT, MRI, scintigraphy. Parathyroid based on longer retention tracer than thyroid tissue. Because frequent association adenomas nodular goiter, optimal combination ultrasonography. Different protocols are used scintigraphy, depending institutional logistics experience (classical dual-phase various subtraction radioiodine (99m)Tc-pertechnetate). MIP greatly aided guidance a gamma-probe, vivo radioactivity counting after injection (99m)Tc-sestamibi. gamma-probe-guided different timing doses injected. Gamma-probe-guided very attractive treat patients primary solitary adenoma. procedure technically easy, safe, low morbidity rate, better cosmetic results lower overall cost exploration. Specific guidelines should followed when selecting MIP.