Minimally invasive radioguided parathyroid surgery: A literature review

Desiato, Vincenzo; Melis, Marcovalerio; Amato, Bruno; Bianco, Tommaso; Rocca, Aldo; Amato, Maurizio; Quarto, Gennaro; Benassai, Giacomo

doi:10.1016/j.ijsu.2015.12.037

Cited by 49 publications

(25 citation statements)

References 156 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other clinical applications have been investigated and RGS has been applied with variable results to many neoplasm, as parathyroid adenoma and osteoid osteoma [12,13].…”

Section: Introductionmentioning

confidence: 99%

Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs

2017

View full text Add to dashboard Cite

show abstract

“…Other clinical applications have been investigated and RGS has been applied with variable results to many neoplasm, as parathyroid adenoma and osteoid osteoma [12,13].…”

Section: Introductionmentioning

confidence: 99%

Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs

2017

View full text Add to dashboard Cite

show abstract

“…On a separate day, parathyroidectomy is performed with the aid of a gamma probe by administering sestamibi again on the day of surgery. [36] In some centers, 10-20 mCi iv Tc99m sestamibi is administered 1-2 h before the operation. [37,38] In some other centers, preoperative scintigraphy is performed, and a low dose (1 mCi/37 MBq) of sestamibi was administered a few minutes before the surgery to patients with presumptive parathyroid adenoma who are also scheduled for surgery, and then parathyroidectomy is performed under the guidance of a gamma probe.…”

Section: Intraoperative Use Of a Gamma Probementioning

confidence: 99%

“…The radioactivity counts have been estimated from the bed where the lesion is removed, from the area of the thyroid tract through the skin, or from the lung apex on the opposite side of the arm where the radioactive material is injected after the lesion was removed. [36] Ideal candidates for gamma probe-guided parathyroidectomy are patients undergoing first-time or redo parathyroid surgery, patients with non-nodular thyroid disease or a single gland disease based on scanning results, and patients with sporadic pHPT whose single gland disease was confirmed with USG. [47] The potential advantages of gamma probe-guided surgery are facilitation of especially surgery particularly focused parathyroidectomy, shortening of operative time, identification of the pathological ectopic parathyroid gland, and its ability to confirm surgical success.…”

Section: Intraoperative Use Of a Gamma Probementioning

confidence: 99%

Primer Hiperparatiroidizmde Cerrahi Tedavi: Kime Hangi Tedavi?

Aygün

Uludağ

2019

Sisli Etfal

View full text Add to dashboard Cite

Intraoperative Adjunct Methods for Localization in Primary Hyperparathyroidism T he curative treatment of primary hyperparathyroidism (pHPT) is surgery. The causative agent of the disease in pHPT is parathyroid adenomas originating from a single gland in 80-85% of the cases. After the third quarter of the last century, preoperative imaging methods have been rapidly developed, most of the pathological glands could be determined. In addition, intraoperative gamma probe application, ultrasonography (USG), methylene blue, and/ or frozen section examination are being used to increase the success in parathyroidectomy. Recently, promising studies regarding different parathyroid imaging modalities with optical technologies to identify the intraoperative parathyroid glands have been noteworthy. Currently, bilateral neck exploration (BNE) is the gold standard in the surgical treatment of pHPT. [1] However, with the contribution of imaging modalities and especially intraoperative parathyroid hormone (PTH) mea-Primary hyperparathyroidism (pHPT) is a frequently seen endocrine disease, and its main treatment is surgery. In the majority of pHPT, the disease involves only a single gland, and the majority of the pathological glands can be determined by preoperative localization methods.In addition to preoperative localization studies in parathyroidectomy, the use of adjunct methods to improve intraoperative localization in order to increase success of surgery is becoming widespread. These methods include different approaches, mainly intraoperative parathyroid hormone (PTH) measurement, followed by intraoperative gamma probe application, intraoperative ultrasonography, parathyroid imaging with methylene blue, and frozen section examination. Recently, especially promising new imaging methods have been described in the literature with various optical technologies to increase the localization of the parathyroid glands and to evaluate their viability. These methods include parathyroid imaging with autofluorescence, indocyanine green imaging with autofluorescence, autofluorescence imaging with methylene blue, autofluorescence imaging with 5-aminolevulinic acid, optical coherence tomography, laser speckle contrast imaging, dynamic optical contrast imaging, and Raman spectroscopy. Currently, minimally invasive parathyroidectomy has become the standard treatment for selected pHPT patients with the aid of preoperative imaging and intraoperative auxiliary methods. The aim of the present study was to evaluate the routinely used new promising intraoperative adjunct methods in pHPT.

show abstract

“…In all cases, however, the identification and preservation of the RLN, of the SLN and of the parathyroid glands are still key points of the operation which must be carried out with regards to the principles of classical technique and require adequate training in high volume centres. Intra-operative parathormone dosage together with radioguided technique and minimally invasive approach reduced the rate of recurrent hyperparathyroidism after parathyroidectomy for primary hyperparathyroidism thus containing the rate of reoperation with the related increased morbidity [ 39 - 40 ].…”

Section: Technologymentioning

confidence: 99%

Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation

et al. 2016

View full text Add to dashboard Cite

AbstractAim of the present paper is the review of the principal complications associated to endocrine neck surgery considering how expertise, full adoption of guidelines, appropriate technology and proper informed consent may limit the medicolegal claims at the light of the incoming new regulation of the medical professional legal responsibility. A literature search, using the Medline/PubMed database for full-length papers, was used. Postoperative recurrent laryngeal nerve (RLN) palsy and hypoparathy-roidism remain the principal causes of surgical malpractice claims . In the procedure of neck lymphadenctomy intra-operative haemorrhage, thoracic duct injury, injuries to loco-regional nerves can be observed and can be source of claims. After many years of increased medicolegal litigations, the Italian government is proposing a drastic change in the regulations of supposed medical malpractice in order to guarantee the patient’s right to a safe treatment and in the meantime to defend clinicians from often unmotivated and prejudicial legal cases. Surgical errors and complications in neck surgery are a relevant clinical issue. Only the combination of surgical and clinical expertise, application of guidelines, appropriate technology and a routinely use of specific informed consent can contain potential medicolegal implications.

show abstract

Minimally invasive radioguided parathyroid surgery: A literature review

Cited by 49 publications

References 156 publications

Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs

Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs

Primer Hiperparatiroidizmde Cerrahi Tedavi: Kime Hangi Tedavi?

Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation

Contact Info

Product

Resources

About