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Korean Journal of Head & Neck Oncology 2009;25(2):138-142.
Published online November 30, 2009.
Usefulness of Minimally Invasive Radio-Guided Parathyroidectomy in Patients with Prior Central Neck Exploration
Sung Hwan Lee;Bup Woo Kim;Kuk Jin Kim;Yong Sang Lee;Jong Ju Jeong;Kee-Hyun Nam;Woong Youn Chung;Hang-Seok Chang;Cheong Soo Park
중앙 경부 수술의 과거력이 있는 환자에서의 방사능 유도 최소 침습 부갑상선 절제술의 유용성
Introduction :Althouth bilateral exploration has been thought to be the standard therapeutic modality for primary hyperparathyroidism(pHPT) due to the admirable cure rate, questions have remained as to whether bi-lateral neck exploration for all patients with pHPT is needed because 80-85% of patients with pHPT have a single parathyroid adenoma. If the diseased parathyroid can be determined preoperatively, a directed and min-imal operation is appropriate using the recent innovations of preoperative diagnosis and operation techniques for parathyroid diseases, the radio-guided parathyroid surgery(RGPS) is one of the standards. In especial, RGPS has been reported beneficial in special circumstances, such as in recurrent disease, ectopic parathyroid, and in mediastinal parathyroid. It can be also useful for the parathyroid disease in previously explored or irradiated neck. Material and Methods :We experienced 2 cases of pHPT successfully treated by RGPS in who previously un-derwent extensive neck dissection and concomitant external or internal radiotherapy. We adopted and modified the technique described by Dr. James Norman at the University of South Florida-the minimally invasive para-thyroidectomy using intraoperative nuclear mapping with 99mTc-sestamibi scanning and radioactivity detection probe. Results :We acquired the successful results for these patients. Conclusion :RGPS is thought to be the alternative technique for the patients with prior central neck exploration and irradiation.
Key Words: Primary hyperparathyroidism, Radio-guided parathyroid surgery
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