Potential role for intraoperative gamma probe identification of normal parathyroid glands. Am J Surg 2003 Dec;186(6):711-7
Date
12/16/2003Pubmed ID
14672784DOI
10.1016/j.amjsurg.2003.08.021Scopus ID
2-s2.0-0346220400 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
BACKGROUND: Patients undergoing central neck surgery are at risk for hypoparathyroidism. We hypothesized that gamma probe identification of sestamibi-labeled parathyroid glands might help maximize parathyroid preservation.
METHODS: Records of 351 patients who underwent central neck surgery were reviewed. A subgroup of patients underwent sestamibi injection followed by gamma probe-directed parathyroid gland identification.
RESULTS: Operation was performed for malignancy in 73% of patients and represented a reoperation in 34%. Persistent hypoparathyroidism was more common in patients who underwent reoperation versus a primary operation (6.8% versus 1.7%; P = 0.02). Thirteen patients underwent gamma probe-directed identification of sestamibi-labeled parathyroid glands; in 6 of these patients, sestamibi-labeled parathyroid glands were salvaged from the resected specimens and autografted. None of these 13 patients developed persistent hypoparathyroidism.
CONCLUSIONS: Patients undergoing reoperative central neck surgery are at increased risk for postoperative hypoparathyroidism. Gamma probe-directed salvage of sestamibi-labeled parathyroid glands may help maximize parathyroid preservation, especially in complex or reoperative central neck surgery.
Author List
Pederson LC, Shapiro SE, Fritsche HA Jr, Delpassand ES, Gagel RF, Sherman SI, Vassilopoulou-Sellin R, Evans DB, Lee JEAuthor
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Gamma CamerasHumans
Hypocalcemia
Hypoparathyroidism
Intraoperative Period
Lymph Node Excision
Monitoring, Intraoperative
Neck
Parathyroid Glands
Parathyroid Hormone
Postoperative Complications
Radionuclide Imaging
Radiopharmaceuticals
Reoperation
Retrospective Studies
Technetium Tc 99m Sestamibi
Thyroidectomy