title: Radio-guided excision of parathyroid lesions in patients who had previous neck surgeries: a safe and easy technique for re-operative parathyroid surgery.
abstract: BACKGROUND
  Several methods have been recommended to detect parathyroid lesions in patients who have previously undergone neck surgeries, including radio-guided surgery or intraoperative ultrasounds. In this study, we aimed to investigate whether the radio-guided excision of pathologic parathyroid lesions allowed us to find affected lesions in patients who had previously undergone neck operations.
  
  
  METHODS
  This prospective study included 18 patients with primary hyperparathyroidism who had previously undergone neck surgeries. The pathologic parathyroid lesions were localized by ultrasonography, and a radiotracer was injected directly into the lesions.
  
  
  RESULTS
  Careful dissections were carried out by following the area of maximum radioactivity until the lesions were identified and excised. Eighteen parathyroid adenomas were removed in 18 patients. The median count from each lesion was significantly higher than the values measured from the adjacent tissues and the lesion beds (12550/20 s, 370/20 s, and 35/20 s, respectively; p < 0.001).
  
  
  CONCLUSIONS
  Radio-guided excision of parathyroid lesions can be performed safely for re-operative parathyroid surgery.
authors.affiliation: Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Çapa, İstanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Sarı
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Erbil
authors.forename: Feyzullah
authors.initials: F
authors.lastname: Ersöz
authors.forename: Aydemir
authors.initials: A
authors.lastname: Olmez
authors.forename: Artür
authors.initials: A
authors.lastname: Salmaslıoğlu
authors.forename: Işık
authors.initials: I
authors.lastname: Adalet
authors.forename: Nese
authors.initials: N
authors.lastname: Colak
authors.forename: Selçuk
authors.initials: S
authors.lastname: Özarmağan
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012086:Reoperation / Q000379:methods; D014463:Ultrasonography; D055815:Young Adult