title: Minimally invasive radioguided parathyroidectomy performed for primary hyperparathyroidism.
abstract: OBJECTIVE
  Parathyroid surgery is often challenging due to considerable variability in anatomy. Minimally invasive radioguided parathyroidectomy (MIRP) is a directed surgical approach that has been made possible by the advent of new imaging techniques, specifically sestamibi scanning. In this study, we review our experience and outcomes with MIRP in one of the largest case series reported in the literature.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Subjects were 305 patients who underwent MIRP in our institution between 1997 and 2007. Data including symptoms, preoperative and postoperative calcium levels, and PTH levels were collected. Analyses were performed using Excel AnalysisPak.
  
  
  RESULTS
  MIRP in this series had a 100 percent rate of success in removing a hyperfunctional parathyroid gland. The mean preoperative calcium was 10.9 whereas the mean postoperative level was 9.8. There was a significant difference between preoperative and postoperative calcium levels (both ionized and total) (P<0.01). Mean preoperative and postoperative serum PTH levels were 138 and 50, respectively. PTH levels were therefore significantly lower postoperatively (P<0.01). Rapid PTH testing showed a similar pattern. There were no cases of recurrent laryngeal nerve palsy.
  
  
  CONCLUSIONS
  MIRP is an effective method for removal of image-localized hyperfunctional parathyroid glands.
authors: Division of Otolaryngology-Head and Neck Surgery, Pennsylvania State College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA.
authors: Eelam
authors: E
authors: Adil
authors: Tabrez
authors: T
authors: Adil
authors: Fred
authors: F
authors: Fedok
authors: Gordon
authors: G
authors: Kauffman
authors: David
authors: D
authors: Goldenberg
mesh_terms: D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016105:Parathyroidectomy / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi