Tài liệu Báo cáo y học: "Minimally Invasive Parathyroidectomy Using Surgical Sonography"

Primary hyperparathyroidism (pHPT) is a common endocrine disorder, which can affect 1 in 700 people. In 80% of cases the cause is a solitary parathyroid adenoma. Recently the use of perioperative 99mTc-sestamibi with intraoperative localization has led to the development of minimally invasive para thyroidectomy (MIP) [1,2]. This technique facilitates unilateral neck dissection with less surgical trauma and shortens hospital stay compared with four-gland exploration. However, MIP requires an intraoperative gamma probe, which necessitates either scheduled 99mTc-sestamibi injection on the day of surgery with preoperative scanning and intraoperative measurement of gamma emission or 99mTc-sestamibi injection on different days: one preoperative scan and an-other for intraoperative gamma emission. This may not only complicate scheduling for surgery but also exposes patients and medical personnel to an unnec-essary dose of radioactivity. Ultrasound provides an excellent modality for visualizing structures in the neck[3]. Up to 90% of parathyroid adenomas can be visualized with ultrasound. We previously suggested intraoperative ultrasonograpy as a viable localizing modality [4].