Sema YÜKSEKDAĞ, Ahmet TOPÇU, Fatma Gülçiçek AYRANCI, Esin CIBIROĞLU, Ethem ÜNAL

The Place of Preoperative Imaging Scans In Parathyroid Surgery

Aim of this study was to evaluate early postoperative results of patients operated for hyperparathyroidism. Demographics, underlying diseases, preoprative localization scans and efficacy of surgical techniques applied were evaluated in patients with hyperparathyroidism, operated by one surgeon between 2014 and 2017. Mean age of total 14 patients was 56.6 (range, 22-73). The success rate of ultrasonography applied in all patients (USG, 100 %) was 71.4%. Scintigraphy was done in all patients (100%); localization was wrong in two (14.2%) and false negative ratio was 28.5 % (n=4). Computed tomography and magnetic resonance were used in 17.2 and 28.5%, respectively. Mean preoperative serum calcium level of 11.9 mg/dL (range, 10.6-18.2) was normalized to 8.8 mg/dL (range, 7.1-10.1) in a follow-up of 26 months (range, 6-44). The most common involvements were right lower (n=6, %50) and left lower glands (n=4, %33). Most important surgical indications were adenoma (n=12, 85.7%) and tertiary hyperparathyroidism in kidney transplant patients (n=2, 14.2%). Histopathology revealed adenoma diameter as 1.4 cm (range, 0.5-4). There was no permanent morbidity. Although the importance of noninvasive localization studies for effective surgical treatment of hyperparathyroidism is generally accepted, bilateral neck dissection and intraoperative exploration seem sine qua non.

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