AB130. SOH24AB_066. Evaluating the combined approach of three intra-operative adjuncts in localizing parathyroid adenomas during minimally invasive radio-guided parathyroidectomy: a single center retrospective analysis
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AB130. SOH24AB_066. Evaluating the combined approach of three intra-operative adjuncts in localizing parathyroid adenomas during minimally invasive radio-guided parathyroidectomy: a single center retrospective analysis

Hilal Al-Harthi, Aine Lucy, Sharjeel Paul, Henry Redmond

Department of Endocrine Surgery, Cork University Hospital, Wilton, Co. Cork, Ireland

Background: Primary hyperparathyroidism affects approximately 0.8% of the population across Ireland and the UK. It is a common cause of hypercalcemia, with surgery being the mainstay of treatment. In the majority of cases of primary hyperparathyroidism there is single gland disease. There are a variety of techniques used to localize the pathological gland both preoperatively and intraoperatively. Institutions and surgeons utilize different intraoperative adjuncts in different protocols with varying results. The purpose of this article is to critically evaluate the combined use of all three intra-operative adjuncts used in parathyroid surgery to assess their utility, accuracy and their added value to the surgeon, as experienced at our center.

Methods: We retrospectively analyzed a database of patients who underwent minimally invasive radio-guided parathyroidectomy (MIRP) surgery in our unit to determine the sensitivity, positive predictive value and accuracy of intra-operative parathyroid hormone (PTH) assay, the Norman 20% rule and frozen section analysis in detecting parathyroid adenomas.

Results: From July 2018 until September 2022, 151 patients underwent MIRP by one surgeon at the Department of Surgical Oncology in Cork University Hospital. Of these, 18 did not have intraoperative frozen section analysis and so were not included in the study. The 50% rule was positive in 128/133 cases, The 20% rule was positive in 128/133 cases, Frozen section analysis was positive in 129/133 cases.

Conclusions: Our study has proven that using three adjuncts (including intraoperative PTH, frozen section and gamma probe) rather than one in isolation, improves the overall success of MIRP surgery in excising pathologic parathyroid glands.

Keywords: Frozen section; intraoperative adjunct localization; intraoperative parathyroid hormone (intraoperative PTH); primary hyperparathyroidism; technetium gamma probe

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab130
Cite this abstract as: Al-Harthi H, Lucy A, Paul S, Redmond H. AB130. SOH24AB_066. Evaluating the combined approach of three intra-operative adjuncts in localizing parathyroid adenomas during minimally invasive radio-guided parathyroidectomy: a single center retrospective analysis. Mesentery Peritoneum 2024;8:AB130.

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