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Article: Minimally invasive endoscopic-assisted parathyroidectomy for primary hyperparathyroidism

TitleMinimally invasive endoscopic-assisted parathyroidectomy for primary hyperparathyroidism
Authors
KeywordsAdenoma
Endoscopic-assisted parathyroidectomy
Minimally invasive surgery
Parathyroid gland
Primary hyperparathyroidism
Issue Date2003
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2003, v. 17 n. 12, p. 1932-1936 How to Cite?
AbstractBackground: Minimally invasive surgery for primary hyperparathyroidism (pHPT) depends on both an accurate preoperative localization and the availability of intraoperative parathyroid hormone monitoring. Methods: Patients with sporadic pHPT and one unequivocally enlarged parathyroid gland on preoperative imaging underwent endoscopic-assisted parathyroidectomy. Intraoperative rapid parathyroid hormone (quick PTH) monitoring was performed, and surgical success was confirmed when there was a > 50% decrease in quick PTH level 10 min after excision as compared with the baseline level at induction. The surgical outcome and the use of preoperative localization, together with the role played by quick PTH assay in enhancing the operative success, were evaluated. Results: From 1999 to 2002, 66 of 107 patients (62%) were selected for this approach. The accuracy of 99mTc-Sestamibi scintigraphy and ultrasonography was 97% and 70%, respectively. Conversion was required in four cases due to technical problems, and four additional patients failed to show a significant decline in quick PTH levels postexcision. Two patients underwent cervical exploration without the finding of any additional pathology, and another two patients had a delayed drop in quick PTH that was confirmed 30 min postexcision. All patients had a solitary adenoma and were cured of hypercalcemia during a median follow-up of 9 months. Conclusions: Minimally invasive endoscopic-assisted parathyroidectomy can be performed expeditiously in a select group of patients based on 99mTc-Sestamibi scintigraphy. The use of quick PTH assay can ensure surgical success, but careful interpretation of the results is mandatory.
Persistent Identifierhttp://hdl.handle.net/10722/83616
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CYen_HK
dc.contributor.authorChan, WFen_HK
dc.contributor.authorLuk, JMen_HK
dc.date.accessioned2010-09-06T08:43:08Z-
dc.date.available2010-09-06T08:43:08Z-
dc.date.issued2003en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2003, v. 17 n. 12, p. 1932-1936en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83616-
dc.description.abstractBackground: Minimally invasive surgery for primary hyperparathyroidism (pHPT) depends on both an accurate preoperative localization and the availability of intraoperative parathyroid hormone monitoring. Methods: Patients with sporadic pHPT and one unequivocally enlarged parathyroid gland on preoperative imaging underwent endoscopic-assisted parathyroidectomy. Intraoperative rapid parathyroid hormone (quick PTH) monitoring was performed, and surgical success was confirmed when there was a > 50% decrease in quick PTH level 10 min after excision as compared with the baseline level at induction. The surgical outcome and the use of preoperative localization, together with the role played by quick PTH assay in enhancing the operative success, were evaluated. Results: From 1999 to 2002, 66 of 107 patients (62%) were selected for this approach. The accuracy of 99mTc-Sestamibi scintigraphy and ultrasonography was 97% and 70%, respectively. Conversion was required in four cases due to technical problems, and four additional patients failed to show a significant decline in quick PTH levels postexcision. Two patients underwent cervical exploration without the finding of any additional pathology, and another two patients had a delayed drop in quick PTH that was confirmed 30 min postexcision. All patients had a solitary adenoma and were cured of hypercalcemia during a median follow-up of 9 months. Conclusions: Minimally invasive endoscopic-assisted parathyroidectomy can be performed expeditiously in a select group of patients based on 99mTc-Sestamibi scintigraphy. The use of quick PTH assay can ensure surgical success, but careful interpretation of the results is mandatory.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.subjectAdenomaen_HK
dc.subjectEndoscopic-assisted parathyroidectomyen_HK
dc.subjectMinimally invasive surgeryen_HK
dc.subjectParathyroid glanden_HK
dc.subjectPrimary hyperparathyroidismen_HK
dc.titleMinimally invasive endoscopic-assisted parathyroidectomy for primary hyperparathyroidismen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0930-2794&volume=17&issue=12&spage=1932&epage=1936&date=2003&atitle=Minimally+invasive+endoscopic-assisted+parathyroidectomy+for+primary+hyperparathyroidismen_HK
dc.identifier.emailLuk, JM: jmluk@hkucc.hku.hken_HK
dc.identifier.authorityLuk, JM=rp00349en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-003-9072-2en_HK
dc.identifier.pmid14574548-
dc.identifier.scopuseid_2-s2.0-0347031603en_HK
dc.identifier.hkuros85250en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0347031603&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume17en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1932en_HK
dc.identifier.epage1936en_HK
dc.identifier.isiWOS:000220310100012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, CY=36151700700en_HK
dc.identifier.scopusauthoridChan, WF=7403918455en_HK
dc.identifier.scopusauthoridLuk, JM=7006777791en_HK

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