New operative strategies in primary hyperparathyroidism

H. Takami, Y. Ikeda, S. Kan, Kaori Kameyama

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

More than 95% of patients with primary hyperparathyroidism have been treated with bilateral neck exploration by experienced surgeons. This procedure has been performed without employing preoperative localization tests or specialized techniques of intraoperative measurement. A renewed interest in unilateral neck exploration for primary hyperparathyroidism emerged (in three developments), in an attempt to maintain the excellent cure rate and to minimize the invasiveness of the procedure. The first development was the introduction of sestamibi scintigrams as a new preoperative localization technique and intraoperative nuclear mapping with a hand-held gamma probe. The localization of adenomas using this technique was much more accurate than that of previous localization studies, allowing unilateral procedures to become feasible. Sestamibi guidance enables parathyroidectomies to be performed much more rapidly through a significantly less invasive dissection. Secondly, the intraoperative quick parathyroid hormone assay allows the confirmation of removal of the parathyroid mass. The third development was endoscopic parathyroidectomy. Various approaches have been shown to be technically feasible, including endoscopic procedures that rely on CO2 insufflation to create a working space or video-assisted procedures in which the working space is maintained through conventional external retraction. Given the safety and high success rate of the standard exploration, the potential advantages of these new strategies include decreased operating time, local or regional anaesthesia rather then general anaesthesia, and smaller incisions.

Original languageEnglish
Pages (from-to)184-187
Number of pages4
JournalAsian Journal of Surgery
Volume25
Issue number2
Publication statusPublished - 2002

Fingerprint

Primary Hyperparathyroidism
Parathyroidectomy
Neck
Insufflation
Conduction Anesthesia
Local Anesthesia
Parathyroid Hormone
Adenoma
General Anesthesia
Dissection
Hand
Safety

ASJC Scopus subject areas

  • Surgery

Cite this

New operative strategies in primary hyperparathyroidism. / Takami, H.; Ikeda, Y.; Kan, S.; Kameyama, Kaori.

In: Asian Journal of Surgery, Vol. 25, No. 2, 2002, p. 184-187.

Research output: Contribution to journalArticle

Takami, H, Ikeda, Y, Kan, S & Kameyama, K 2002, 'New operative strategies in primary hyperparathyroidism', Asian Journal of Surgery, vol. 25, no. 2, pp. 184-187.
Takami, H. ; Ikeda, Y. ; Kan, S. ; Kameyama, Kaori. / New operative strategies in primary hyperparathyroidism. In: Asian Journal of Surgery. 2002 ; Vol. 25, No. 2. pp. 184-187.
@article{0a6a020d92e148f09eb40ad0a7a01234,
title = "New operative strategies in primary hyperparathyroidism",
abstract = "More than 95{\%} of patients with primary hyperparathyroidism have been treated with bilateral neck exploration by experienced surgeons. This procedure has been performed without employing preoperative localization tests or specialized techniques of intraoperative measurement. A renewed interest in unilateral neck exploration for primary hyperparathyroidism emerged (in three developments), in an attempt to maintain the excellent cure rate and to minimize the invasiveness of the procedure. The first development was the introduction of sestamibi scintigrams as a new preoperative localization technique and intraoperative nuclear mapping with a hand-held gamma probe. The localization of adenomas using this technique was much more accurate than that of previous localization studies, allowing unilateral procedures to become feasible. Sestamibi guidance enables parathyroidectomies to be performed much more rapidly through a significantly less invasive dissection. Secondly, the intraoperative quick parathyroid hormone assay allows the confirmation of removal of the parathyroid mass. The third development was endoscopic parathyroidectomy. Various approaches have been shown to be technically feasible, including endoscopic procedures that rely on CO2 insufflation to create a working space or video-assisted procedures in which the working space is maintained through conventional external retraction. Given the safety and high success rate of the standard exploration, the potential advantages of these new strategies include decreased operating time, local or regional anaesthesia rather then general anaesthesia, and smaller incisions.",
author = "H. Takami and Y. Ikeda and S. Kan and Kaori Kameyama",
year = "2002",
language = "English",
volume = "25",
pages = "184--187",
journal = "Asian Journal of Surgery",
issn = "1015-9584",
publisher = "Elsevier Taiwan LLC",
number = "2",

}

TY - JOUR

T1 - New operative strategies in primary hyperparathyroidism

AU - Takami, H.

AU - Ikeda, Y.

AU - Kan, S.

AU - Kameyama, Kaori

PY - 2002

Y1 - 2002

N2 - More than 95% of patients with primary hyperparathyroidism have been treated with bilateral neck exploration by experienced surgeons. This procedure has been performed without employing preoperative localization tests or specialized techniques of intraoperative measurement. A renewed interest in unilateral neck exploration for primary hyperparathyroidism emerged (in three developments), in an attempt to maintain the excellent cure rate and to minimize the invasiveness of the procedure. The first development was the introduction of sestamibi scintigrams as a new preoperative localization technique and intraoperative nuclear mapping with a hand-held gamma probe. The localization of adenomas using this technique was much more accurate than that of previous localization studies, allowing unilateral procedures to become feasible. Sestamibi guidance enables parathyroidectomies to be performed much more rapidly through a significantly less invasive dissection. Secondly, the intraoperative quick parathyroid hormone assay allows the confirmation of removal of the parathyroid mass. The third development was endoscopic parathyroidectomy. Various approaches have been shown to be technically feasible, including endoscopic procedures that rely on CO2 insufflation to create a working space or video-assisted procedures in which the working space is maintained through conventional external retraction. Given the safety and high success rate of the standard exploration, the potential advantages of these new strategies include decreased operating time, local or regional anaesthesia rather then general anaesthesia, and smaller incisions.

AB - More than 95% of patients with primary hyperparathyroidism have been treated with bilateral neck exploration by experienced surgeons. This procedure has been performed without employing preoperative localization tests or specialized techniques of intraoperative measurement. A renewed interest in unilateral neck exploration for primary hyperparathyroidism emerged (in three developments), in an attempt to maintain the excellent cure rate and to minimize the invasiveness of the procedure. The first development was the introduction of sestamibi scintigrams as a new preoperative localization technique and intraoperative nuclear mapping with a hand-held gamma probe. The localization of adenomas using this technique was much more accurate than that of previous localization studies, allowing unilateral procedures to become feasible. Sestamibi guidance enables parathyroidectomies to be performed much more rapidly through a significantly less invasive dissection. Secondly, the intraoperative quick parathyroid hormone assay allows the confirmation of removal of the parathyroid mass. The third development was endoscopic parathyroidectomy. Various approaches have been shown to be technically feasible, including endoscopic procedures that rely on CO2 insufflation to create a working space or video-assisted procedures in which the working space is maintained through conventional external retraction. Given the safety and high success rate of the standard exploration, the potential advantages of these new strategies include decreased operating time, local or regional anaesthesia rather then general anaesthesia, and smaller incisions.

UR - http://www.scopus.com/inward/record.url?scp=0036015720&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036015720&partnerID=8YFLogxK

M3 - Article

C2 - 12376244

AN - SCOPUS:0036015720

VL - 25

SP - 184

EP - 187

JO - Asian Journal of Surgery

JF - Asian Journal of Surgery

SN - 1015-9584

IS - 2

ER -