Elizabeth G Grubbs1, Elizabeth A Mittendorf, Nancy D Perrier, Jeffrey E Lee. 1. Section of Endocrine Tumor Surgery, Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1400 Holcombe Boulevard, Box 301402, Houston, TX 77030-4009, USA.
Abstract
BACKGROUND: We evaluated gamma probe identification (GPI) of sestamibi-labeled normal parathyroid glands during central neck surgery. METHODS: GPI was judged to be helpful if it resulted in the identification of parathyroid glands not identified by direct inspection. RESULTS: GPI was performed in 54 patients and was helpful in 20, including 9 patients in whom GPI identified intact parathyroid glands in vivo and 11 patients in whom GPI identified incidentally excised parathyroid glands ex vivo in the central neck dissection (CND) specimen. GPI was more commonly helpful in patients who underwent reoperation (9/16, 56%) compared with primary surgery (11/38, 29%; P = .04) and was more commonly helpful in patients who underwent CND (17/28, 61%) compared with thyroidectomy without CND (2/26, 8%; P < .0001). In 11 patients, normal parathyroid glands were salvaged by GPI from the ex vivo CND specimens and autografted. CONCLUSIONS: GPI is a relatively simple and effective technique that may help maximize parathyroid preservation.
BACKGROUND: We evaluated gamma probe identification (GPI) of sestamibi-labeled normal parathyroid glands during central neck surgery. METHODS:GPI was judged to be helpful if it resulted in the identification of parathyroid glands not identified by direct inspection. RESULTS:GPI was performed in 54 patients and was helpful in 20, including 9 patients in whom GPI identified intact parathyroid glands in vivo and 11 patients in whom GPI identified incidentally excised parathyroid glands ex vivo in the central neck dissection (CND) specimen. GPI was more commonly helpful in patients who underwent reoperation (9/16, 56%) compared with primary surgery (11/38, 29%; P = .04) and was more commonly helpful in patients who underwent CND (17/28, 61%) compared with thyroidectomy without CND (2/26, 8%; P < .0001). In 11 patients, normal parathyroid glands were salvaged by GPI from the ex vivo CND specimens and autografted. CONCLUSIONS:GPI is a relatively simple and effective technique that may help maximize parathyroid preservation.