Radioguided occult lesion localization for minimally-invasive parathyroidectomy without quick PTH monitoring and frozen section: impact of the learning curve
Lütfi Soylu1
, Oğuz Uğur Aydın1, Seyfettin Ilgan2, Serdar Özbaş1, Banu Bilezikçi3, Alptekin Gürsoy4, Savaş Koçak1
1Ankara Güven Hastanesi , Endokrin Cerrahi , Ankara, Turkey
2Ankara Güven Hastanesi, Nükleer Tıp , Ankara, Turkey
3Ankara Güven Hastanesi , Patoloji , Ankara, Turkey
4Ankara Güven Hastanesi , Endokrinoloji, Ankara, Turkey
Abstract
Objectives: Minimally-invasive parathyroidectomy (MIP) is a surgical procedure that reduces the duration of operation, hospital costs, and hypocalcemia, and shortens the length of hospital stay. This study addressed the important procedural details of the radioguided occult lesion localization (ROLL)-MIP technique and evaluated the consequences of the learning curve from a series of patients.
Patients and Methods: A total of 80 patients who underwent ROLL-MIP for a single parathyroid adenoma were included into this retrospective study. In order to analyze the effect of the learning curve, these subjects were then divided into 2 groups per time period and the operative times were compared. Group A consisted of 22 previously reported patients who served as the control group. Group B consisted of 58 consecutive patients.
Results: Serum calcium and parathyroid hormone (PTH) levels were normalized in all of the patients within 2 days and remained normal during the follow-up period (31 ± 18.5 months). None of the patients who underwent ROLL-guided parathyroidectomy suffered temporary or permanent recurrent laryngeal nerve injuries. Mean operation time (time from incision to excision of the adenoma) was 23 ± 6 min in Group A and 18 ± 7 min in Group B. Mean operative times were significantly shorter in group B.
Conclusion: The success of MIP administered with the ROLL technique in a single adenomatous patient was quite high. This method seems especially valuable in patients with atypically located or small adenomas.
Keywords: Parathyroid adenoma, Minimally-invasive parathyroidectomy, Radioguided occult lesion localization.
Ethics committee approval was received for this study from the Local Ethics Committee of Ankara Guven Hospital ( 18.03.2020).
Externally peer-reviewed.
Concept - L.S., O.U.A., S.I., Design - L.S., S.I., S.Ö., O.U.A., Supervision - L.S., B.B., S.Ö., Resource - L.S., S.I., S.Ö., Data Collection and/or Processing - L.S., S.I., B.B., S.K., A.G.; Analysis and Interpretation - S.I., S.K., A.G.; Literature Review - S.K., B.B., A.G.; Writing Manuscript - L.S., S.I., S.Ö.; Critical Reviews - S.I., S.Ö., A.G., S.K., O.U.A.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.