EP 588 Institutional Experience of Focused Parathyroidectomy for Parathyroid Adenoma –a Step Towards Minimally Invasive Endocrine Surgery
Marryam Riaz Farooqui, Hamza Waqar Bhatti, Muhammad Umar Javed, Ibia Nawaz, Aurangzeb Khan, Muhammad HanifAbstract
Introduction
Primary hyperparathyroidism is a common condition caused mostly by a single parathyroid adenoma. Its incidence rises after 50 years of age, particularly in women. Surgery remains the mainstay of treatment for single gland disease, and focused parathyroidectomy is the preferred modality of choice.
Aims
The objective of this study is to assess the safety, feasibility, and adequacy of focused parathyroidectomy using an open lateral approach for single gland adenoma using preoperative positive sestamibi (MIBI) scan and/or ultrasound.
Methods
This is a retrospective cross-sectional study of a total of 12 patients presenting in the Surgical unit II of Benazir Bhutto Hospital diagnosed as having parathyroid adenoma on sestamibi scan or/ and ultrasound scan, undergoing focused parathyroidectomy in 5 years duration.
Results
Of the 21 patients, the mean age was 56.26 ± 12.82 years. All patients were ASA grade I-II. 7 (33.33%) patients presented with recurrent pancreatitis, 8 (38.09%) patients with bilateral renal stones, and 6 (28.57%) patients with both renal and gallstones simultaneously. However, the most common location of parathyroid adenoma was the left lower in 16 of the patients. Median PTH levels before and 10 Minutes after excision of the adenoma were 871.93 pg/ml and 260.52 pg/ml, respectively. 2 (9.52%) patients developed transient nerve paresis.
Conclusion
We conclude that focused parathyroidectomy is a safe and feasible approach for single-gland parathyroid adenoma in patients causing primary hyperthyroidism.