An initial experience with radioguided parathyroid surgery.
BACKGROUND
Recent reports have shown the effectiveness of preoperative parathyroid scintiscanning as an aid to parathyroidectomy. Less attention has been paid to limitations of this approach based on patient characteristics.


METHODS
All patients evaluated for primary hyperparathyroidism by an endocrine surgeon from December 1, 1998, through October 31, 1999, were retrospectively reviewed. Data were gathered to determine which patients were candidates for the radioguided approach, the effectiveness of this approach, and the reasons why some patients were not candidates for this approach.


RESULTS
Thirty-three patients were evaluated. Based on history, 4 patients were not candidates for a radioguided approach. Of the remaining 29 patients, 19 had positive sestamibi scans (65.5%) and successful radioguided operations. The 10 patients (34.5%) with negative scans had successful standard parathyroidectomy.


CONCLUSIONS
Although radioguided parathyroid surgery is an effective surgical approach, only 57.6% of patients in this series could have a radioguided operation. Standard four-gland exploration will continue to be needed for many patients.
Angelos
P
P
Department of Surgery, Division of General Surgery, Northwestern University Medical School, Chicago, Illinois, USA.
D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi