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The place of preoperative imaging scans in parathyroid surgery [Eastern J Med]
Eastern J Med. 2019; 24(3): 280-282 | DOI: 10.5505/ejm.2019.55265  

The place of preoperative imaging scans in parathyroid surgery

Sema Yuksekdag1, Ahmet Topcu1, Fatma Gulcicek Ayranci2, Esin Cibiroglu3, Ethem Unal1
1Department of General Surgery, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
2Department of Pathology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
3Department of Radiology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey

INTRODUCTION: The aim of this article is to evaluate early postoperative results of patients operated for hyperparathyroidism.
METHODS: Demographics, underlying diseases, preoprative localization scans and efficacy of surgical techniques applied were evaluated in patients with hyperparathyroidism, operated by one surgeon between 2014 and 2017.
RESULTS: Mean age of total 14 patients was 56.6 (range, 22-73). The success rate of ultrasonography applied in all patients (USG, 100 %) was 71.4%. Scintigraphy was done in all patients (100 %); localization was wrong in two (14.2%) and false negative ratio was 28.5 % (n=4). Computed tomography and magnetic resonance were used in 17.2 and 28.5%, respectively. Mean preoperative serum calcium level of 11.9 mg/dL (range, 10.6-18.2) was normalized to 8.8 mg/dL (range, 7.1-10.1) in a follow-up of 26 months (range, 6-44). The most common involvements were right lower (n=6, % 50) and left lower glands (n=4, % 33). Most important surgical indications were adenoma (n=12, 85.7 %) and tertiary hyperparathyroidism in kidney transplant patients (n=2, 14.2%). Histopathology revealed adenoma diameter as 1.4 cm (range, 0.5-4). There was no permanent morbidity.
DISCUSSION AND CONCLUSION: Although the importance of noninvasive localization studies for effective surgical treatment of hyperparathyroidism is generally accepted, bilateral neck dissection and intraoperative exploration seem sine qua non.

Keywords: Hyperparathyroidism, surgery, adenoma, renal transplant, imaging studies, neck exploration


Sema Yuksekdag, Ahmet Topcu, Fatma Gulcicek Ayranci, Esin Cibiroglu, Ethem Unal. The place of preoperative imaging scans in parathyroid surgery. Eastern J Med. 2019; 24(3): 280-282

Corresponding Author: Sema Yuksekdag, Türkiye


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