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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2004 December;29(4):189-94

language: English

Controversies on minimally invasive procedures for radio-guided surgery of parathyroid tumours

Rubello D., Pelizzo M. R., Gross M. D., Fig L. M., Shapiro B., Rampin L., Mariani G.


The definitive treatment of primary hyperparathyroidism (PHPT) is the surgical approach which traditionally consists of bilateral neck exploration with visualisation of at least 4 parathyroid glands and removal of the enlarged ones. However, the most frequent cause of PHPT is a solitary parathyroid adenoma so that a limited neck exploration in order to remove the solitary adenoma alone appears adequate to many surgeons. The recent significant improvements achieved in the pre-operative parathyroid localisation techniques, mainly the parathyroid scintigraphy, and the introduction in surgical practice of measurement of quick parathyroid hormone, endoscopic procedures, and intra-operative gamma probes used together specific radiopharmaceuticals allowed to offer the PHPT patient a limited neck exploration as the unilateral neck exploration and the minimally invasive parathyroidectomy. The present article deals with the role of the intra-operative gamma probes used together with specific radiopharmaceuticals, discussing the principal advantages and disadvantages of each currently used radio-guided approach.

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