Our clinical and surgical experience in parathyroid adenomas
Abuzer Dirican1, Hüseyin Yönder1, Serdar Karakaş1, Mustafa Ateş1, Vural Soyer1, Dinçer Özgür1, Bülent Ünal1, İbrahim Şahin2
1İnönü Üniversitesi, Turgut Özal Tıp Merkezi, Genel Cerrahi AD, Malatya
2İnönü Üniversitesi, Turgut Özal Tıp Merkezi, Endokrinoloji ve Metabolizma BD, Malatya
Keywords: Parathyroid adenoma, gamma probe, parathyroidectomy
Abstract
Hyperparathyroidism is the most common cause of hypercalcemia. Treatment of symptomatic and severe hypercalcemia is surgery. In this study, we aimed to evaluate the outcomes of patients who have been treated surgically with diagnosis of parathyroid adenoma.
Data of 36 patients who have been treated surgically with diagnosis of parathyroid adenoma between 2009 and 2012 were analyzed retrospectively.
Forty six patients were female, 7 male and the mean age was 52,2 (range 30-65 years). Patients average parathyroid hormone levels was 421.1 (35-2500) pg / mL and the mean calcium level was 10.5 (8.4-13.3) mg / dl. Neck ultrasonography (n:53), thyroid scintigraphy (n:15) and intraoperative gamma probe (n:8) were used for localization of pathological parathyroid glands. a parathyroid adenoma excision was performed in 19 patients (35,8 %). Total (n:19) or subtotal (n:15) thyroidectomy was performed together with parathyroidectomy due to concomitant nodular goiter. Two patients was reoperated due to still high parathyroid hormone levels 2 weeks after surgery, and parathyroidectomy was performed with using intraoperative gamma probe.
In conclusion, proper preoperative assessment, intraoperative use of gamma probe and through careful exploration of the more experienced surgeons increase the success in parathyroid adenoma surgery.