Surgeon-performed ultrasound: a single institution experience in parathyroid localization.

Full Abstract

BACKGROUND: Ultrasound has been used successfully to localize parathyroid glands. This study evaluates surgeon-performed ultrasound (SUS) for pre-operative parathyroid localization prior to parathyroidectomy. METHODS: In all, 442 patients with primary hyperparathyroidism (HPT) underwent SUS at a single institution. Patients were divided into 2 groups: group 1 (n = 338) had correct localization, and group 2 (n = 104) had incorrect localization. The true-positive (TP) rate and peri-operative findings were compared. TP was defined as localization of all abnormal parathyroids resulting in operative success. A P value >.05 was considered significant. RESULTS: Of 442 patients, 338 (76.5%) had TP results. Group 1 patients were younger (57 vs 63 years; P < .0001) with larger gland size: 2.1 versus 1.8 cm (P = .08). In group 2, 45/104 (43%) patients had false-positive SUS, and 59/104 (57%) had negative studies or missed multiglandular disease (MGD). Group 1 patients had shorter operative times (60 vs 80 min, P = .002), fewer bilateral neck explorations (BNEs) (8% vs 39%; P < .0001), and lower MGD rates (2% vs 19%; P < .0001). Operative failure was 0.3% in group 1 and 9.6% in group 2 (P < .0001). CONCLUSION: Younger patients have a greater rate of correct localization. When SUS correlates with operative findings, MGD is significantly lower and fewer BNEs are performed. Additionally, operations are shorter with a higher success rate.

Author information

Author/s: Jabiev, Azad A (AA); Lew, John I (JI); Solorzano, Carmen C (CC);

Affiliation: Division of Endocrine Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Journal and publication information

Publication Type: Journal Article

Journal: Surgery (Surgery), published in United States. (Language: eng)

Reference: 2009-Oct; vol 146 (issue 4) : pp 569-75; discussion 575-7

Dates: Created 2009/09/30; Completed 2009/10/14;

PMID: 19789014, status: MEDLINE (last retrieved date: 10/14/2009)

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