[Parathyroidectomy: bilateral exploration of the neck vs minimally invasive radioguided treatment]. / Paratiroidectomia: esplorazione bilaterale del collo versus trattamento radio-guidato mini-invasivo.
Minerva Chir
; 60(2): 83-9, 2005 Apr.
Article
em It
| MEDLINE
| ID: mdl-15973213
ABSTRACT
AIM:
In the therapy of primary hyperparathyroidism, the first surgical intervention, if efficacious, can remarkably reduce the incidence of persistence and relapses which are approximately about 5%. At present, the surgical approach of choice should involve the bilateral exploration of the neck.METHODS:
In the light of the high sensibility (91%) and specificity (98.8%) in the localization of parathyroid adenomas obtained by the parathyroid 99mTc-MIBI scintigraphy, we submitted, prospective and at random, between January 2001 and July 2004, 69 patients with primary hyperparathyroidism, to a conventional surgical treatment (bilateral exploration of the neck 35 patients) or minimally-invasive approach (minimally invasive radioguided parathyroidectomy 34 patients). This method consists of the injection of 50 mCi of 99mTc Sestamibi 2 h before the operation and the execution of parathyroid scintigraphy. When the adenoma is evident, we perform an incision of about 4 cm in the neck, 2 cm over the jugulum and the surgical dissection is guided by a probe showing the emission of gamma rays.RESULTS:
The parameters considered in order to compare the 2 groups, i.e. operating time, hospital stay and time of recovery were reduced in a significant way in the group submitted to the minimally invasive radioguided parathyroidectomy (MIRP). There were no complications in the 2 groups. In the follow-up we did not observe cases of persistence or relapses.CONCLUSIONS:
Therefore, we can confirm that the minimally invasive radioguided parathyroidectomy is a safe and efficacious method as well as the bilateral exploration of the neck. Moreover, cost reduction may convince many surgeons to consider MIRP the <<gold standard>> in the management of primary hyperparathyroidism.
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Base de dados:
MEDLINE
Assunto principal:
Paratireoidectomia
/
Procedimentos Cirúrgicos Minimamente Invasivos
/
Hiperparatireoidismo Primário
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
Europa
Idioma:
It
Ano de publicação:
2005
Tipo de documento:
Article