Korean J Endocr Surg.  2014 Sep;14(3):138-143. 10.0000/kjes.2014.14.2.138.

Localization of Parathyroid Adenoma and Minimally Invasive Parathyroidectomy: A Review

• Suh YJ
• Kim SJ
• Lee KE
• Youn YK

• KMID: 2144012
• DOI: http://doi.org/10.0000/kjes.2014.14.2.138

Abstract

More than 80% of cases of patients with sporadic primary hyperparathyroidism are caused by a single parathyroid adenoma. Therefore, traditional bilateral neck exploration has been replaced by minimally invasive parathyroidectomy (MIP) in recent years. Benefits, of MIP include decreased pain and complications, a shorter length of hospital stay, and improved cosmesis. Preoperative imaging studies for localization and intraoperative PTH assay (IoPTH) play an essential role for in MIP. The standard imaging studies are cervical ultrasound and 99mTc sestamibi scanning (with SPECT/CT), while 4D CT is attracting significant interest. The half-life of PTH is less than 5 minutes and PTH rapidly drops after the resection of target lesions. These characteristics of PTH enable IoPTH. If target lesions are localized by recent imaging studies and IoPTH is adopted, MIP can be performed successfully in patients with primary hyperparathyroidism.

Keyword

Primary hyperparathyroidism; Parathyroid adenoma; Minimally invasive surgical procedures

MeSH Terms

Four-Dimensional Computed Tomography
Half-Life
Humans
Hyperparathyroidism, Primary
Length of Stay
Neck
Parathyroid Neoplasms*
Parathyroidectomy*
Surgical Procedures, Minimally Invasive
Technetium Tc 99m Sestamibi
Ultrasonography
Technetium Tc 99m Sestamibi