Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience
Introduction: The cure rate after focused parathyroidectomy (FP) is dependent upon two critical adjuncts- concordant preoperative imaging and intraoperative parathyroid hormone (PTH), a technique which can reliably determine whether any other hyperfunctioning gland or glands are still present after...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=347;epage=352;aulast=Pradhan |
| _version_ | 1819002831082881024 |
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| author | Roma Pradhan Sushil Gupta Amit Agarwal |
| author_facet | Roma Pradhan Sushil Gupta Amit Agarwal |
| author_sort | Roma Pradhan |
| collection | DOAJ |
| description | Introduction: The cure rate after focused parathyroidectomy (FP) is dependent upon two critical adjuncts- concordant preoperative imaging and intraoperative parathyroid hormone (PTH), a technique which can reliably determine whether any other hyperfunctioning gland or glands are still present after resection of the lesion shown by imaging. We wanted to see the cure rate of FP by using these two adjuncts. We also sought to discern whether utilizing the central lab rapid PTH assay will lead to wider acceptance of this FP with intraoperative PTH in resource-constrained countries. This analysis was also undertaken to find out cost-effective way of doing intraoperative PTH by minimizing the samples for intraoperative PTH study. Result: Data were collected on 83 patients with sporadic primary hyperparathyroidism (PHPT) who underwent parathyroidectomy in two tertiary centers between '2009 and 2017'. A total of 75 patients had concordant imaging, while seven had discordant imaging. The sensitivity and specificity of intraoperative PTH in FP was 100%. All the 78 patients who had fall in intraoperative PTH (50%) at 10 min also had fall of more than 50% at 5 min except one patient (98.7%). Conclusion: We strongly advocate routine use of intraoperative PTH in all patients undergoing minimally invasive parathyroidectomy, as this adjunct offers maximum safety for the patient and confidence for the surgeon. Cost can be minimized by utilizing the central laboratory and reducing the number of samples. |
| first_indexed | 2024-12-20T23:11:21Z |
| format | Article |
| id | doaj.art-88fcc8c650d54bf3904598d3525b983d |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-12-20T23:11:21Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-88fcc8c650d54bf3904598d3525b983d2022-12-21T19:23:43ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102019-01-0123334735210.4103/ijem.IJEM_20_19Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experienceRoma PradhanSushil GuptaAmit AgarwalIntroduction: The cure rate after focused parathyroidectomy (FP) is dependent upon two critical adjuncts- concordant preoperative imaging and intraoperative parathyroid hormone (PTH), a technique which can reliably determine whether any other hyperfunctioning gland or glands are still present after resection of the lesion shown by imaging. We wanted to see the cure rate of FP by using these two adjuncts. We also sought to discern whether utilizing the central lab rapid PTH assay will lead to wider acceptance of this FP with intraoperative PTH in resource-constrained countries. This analysis was also undertaken to find out cost-effective way of doing intraoperative PTH by minimizing the samples for intraoperative PTH study. Result: Data were collected on 83 patients with sporadic primary hyperparathyroidism (PHPT) who underwent parathyroidectomy in two tertiary centers between '2009 and 2017'. A total of 75 patients had concordant imaging, while seven had discordant imaging. The sensitivity and specificity of intraoperative PTH in FP was 100%. All the 78 patients who had fall in intraoperative PTH (50%) at 10 min also had fall of more than 50% at 5 min except one patient (98.7%). Conclusion: We strongly advocate routine use of intraoperative PTH in all patients undergoing minimally invasive parathyroidectomy, as this adjunct offers maximum safety for the patient and confidence for the surgeon. Cost can be minimized by utilizing the central laboratory and reducing the number of samples.http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=347;epage=352;aulast=PradhanFocused parathyroidectomyintraoperative PTHpreoperative imaging |
| spellingShingle | Roma Pradhan Sushil Gupta Amit Agarwal Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience Indian Journal of Endocrinology and Metabolism Focused parathyroidectomy intraoperative PTH preoperative imaging |
| title | Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience |
| title_full | Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience |
| title_fullStr | Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience |
| title_full_unstemmed | Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience |
| title_short | Focused parathyroidectomy using accurate preoperative imaging and intraoperative PTH: Tertiary care experience |
| title_sort | focused parathyroidectomy using accurate preoperative imaging and intraoperative pth tertiary care experience |
| topic | Focused parathyroidectomy intraoperative PTH preoperative imaging |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=347;epage=352;aulast=Pradhan |
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