TY - JOUR
T1 - Three new tools for parathyroid surgery
T2 - Expensive and unnecessary?
AU - Ferzli, George
AU - Patel, Samir
AU - Graham, Andre
AU - Shapiro, Kenneth
AU - Li, Hung Kei
PY - 2004/3
Y1 - 2004/3
N2 - BACKGROUND: The intraoperative quick parathyroid hormone assay, the intraoperative gamma probe, and endoscopic parathyroidectomy are three very new techniques developed to facilitate parathyroid surgery. Some hospitals do not have the necessary equipment, and many, like ours, continue to operate in the time-honored way. STUDY DESIGN: We performed a retrospective chart review of 34 such operations, done with the use of Sestamibi scans, but entirely without the newer modalities. RESULTS: Four-gland exploration was carried out on all patients. Operative times ranged from 15 to 165 minutes, with a mean of 47 minutes, and incision lengths ranged from 2 to 3 cm, with a mean of 2.8 cm. There was no mortality, no reoperation, and no vocal cord or recurrent laryngeal nerve injury. Our cure rate was 100%, as determined by a fall in postoperative calcium and parathormone levels. CONCLUSIONS: In our view, the intraoperative parathyroid hormone assay, gamma probe, and endoscopic parathyroidectomy add an entirely unnecessary cost to an operation that can be completed satisfactorily with a preoperative Sestamibi scan and a thorough four-gland exploration.
AB - BACKGROUND: The intraoperative quick parathyroid hormone assay, the intraoperative gamma probe, and endoscopic parathyroidectomy are three very new techniques developed to facilitate parathyroid surgery. Some hospitals do not have the necessary equipment, and many, like ours, continue to operate in the time-honored way. STUDY DESIGN: We performed a retrospective chart review of 34 such operations, done with the use of Sestamibi scans, but entirely without the newer modalities. RESULTS: Four-gland exploration was carried out on all patients. Operative times ranged from 15 to 165 minutes, with a mean of 47 minutes, and incision lengths ranged from 2 to 3 cm, with a mean of 2.8 cm. There was no mortality, no reoperation, and no vocal cord or recurrent laryngeal nerve injury. Our cure rate was 100%, as determined by a fall in postoperative calcium and parathormone levels. CONCLUSIONS: In our view, the intraoperative parathyroid hormone assay, gamma probe, and endoscopic parathyroidectomy add an entirely unnecessary cost to an operation that can be completed satisfactorily with a preoperative Sestamibi scan and a thorough four-gland exploration.
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U2 - 10.1016/j.jamcollsurg.2003.10.014
DO - 10.1016/j.jamcollsurg.2003.10.014
M3 - Article
C2 - 14992734
AN - SCOPUS:1442286181
SN - 1072-7515
VL - 198
SP - 349
EP - 351
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 3
ER -