Abstract
Objective
Parathyroid surgery is often challenging due to considerable variability in anatomy. Minimally invasive radioguided parathyroidectomy (MIRP) is a surgical option that has been made possible by the advent of new imaging techniques, specifically Sestamibi scanning. In this study, we review our experience, methods, and outcomes with MIRP in one of the largest case series reported in the literature.
Methods
A retrospective chart review was performed on 365 patients who underwent MIRP between 1997 and 2007. Data including symptoms, pre- and postoperative calcium levels, and PTH levels were collected. Analyses were performed using Excel AnaylsisPak.
Results
Intraoperatively, an average of 20mCi Tc-99m was injected for Sestamibi scanning. The mean pre-op calcium was 10.9, whereas the mean post-op level was 9.8. There was a significant difference between pre-op and post-op calcium levels (both ionized and total) (p<.01). Mean pre- and post-op PTH levels were 277 and 46 respectively. Rapid PTH levels were therefore significantly lower post-operatively (p<.01).
Conclusions
MIRP is an effective method for removal of parathyroid adenomas. The benefits of MIRP include more accurate localization, shorter operative and recovery time, a shorter hospital stay, and better cosmetic results.
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