PURPOSE: Surgical removal of a mediastinal ectopic parathyroid is always challenging. We attempted to apply intraoperative radio-guided navigation for the minimally invasive focused removal of ectopic hyperparathyroid lesions in the mediastinum, and evaluated its significance. METHODS: Five cases with ectopic mediastinal hyperfunctioning parathyroid were treated by intraoperative radio-guided navigation surgery. MIBI (methoxyisobutylisonitrile)-SPECT (single-photon emission computed tomography) was used to plan the surgical approach. (99m)Tc-MIBI (11.1 MBq/kg) was administered 2 h before surgery, and a handheld gamma probe was used intraoperatively to detect radioactivity in the lesion. RESULTS: Two lesions found on the aortic arch were excised by left thoracoscopic resection. Two other lesions on the tracheal bifurcation were approached by right thoracotomy. We could remove two hidden adenomas by en bloc resection with the adjacent lymph nodes under radio-guidance. Another lesion, located at the ligamentum arteriosum, was excised with sternal division. Accumulations of radioactivity were identified in all lesions removed, with decreased radioactivity in the surgical field. CONCLUSIONS: Intraoperative radio-guided navigation is a useful tool for the focused removal of an ectopic mediastinal parathyroid by providing instant feedback to help guide the surgeon, while also providing precise localization of lesions.
PURPOSE: Surgical removal of a mediastinal ectopic parathyroid is always challenging. We attempted to apply intraoperative radio-guided navigation for the minimally invasive focused removal of ectopic hyperparathyroid lesions in the mediastinum, and evaluated its significance. METHODS: Five cases with ectopic mediastinal hyperfunctioning parathyroid were treated by intraoperative radio-guided navigation surgery. MIBI (methoxyisobutylisonitrile)-SPECT (single-photon emission computed tomography) was used to plan the surgical approach. (99m)Tc-MIBI (11.1 MBq/kg) was administered 2 h before surgery, and a handheld gamma probe was used intraoperatively to detect radioactivity in the lesion. RESULTS: Two lesions found on the aortic arch were excised by left thoracoscopic resection. Two other lesions on the tracheal bifurcation were approached by right thoracotomy. We could remove two hidden adenomas by en bloc resection with the adjacent lymph nodes under radio-guidance. Another lesion, located at the ligamentum arteriosum, was excised with sternal division. Accumulations of radioactivity were identified in all lesions removed, with decreased radioactivity in the surgical field. CONCLUSIONS: Intraoperative radio-guided navigation is a useful tool for the focused removal of an ectopic mediastinal parathyroid by providing instant feedback to help guide the surgeon, while also providing precise localization of lesions.
Authors: Vincent Arnault; Anthony Beaulieu; Jean-Christophe Lifante; Antonio Sitges Serra; Frederic Sebag; Muriel Mathonnet; Antoine Hamy; Michel Meurisse; Bruno Carnaille; Jean-Louis Kraimps Journal: World J Surg Date: 2010-09 Impact factor: 3.352
Authors: Glenda G Callender; Elizabeth G Grubbs; Thinh Vu; Wayne L Hofstetter; Jason B Fleming; Katherine L Woodburn; Jeffrey E Lee; Douglas B Evans; Nancy D Perrier Journal: J Am Coll Surg Date: 2009-05 Impact factor: 6.113
Authors: Kirby Tobin; Rachel R Ayers; Mohammad Rajaei; Rebecca S Sippel; Courtney J Balentine; Dawn Elfenbein; Herb Chen; David F Schneider Journal: Int J Endocr Oncol Date: 2016-02
Authors: Thomas Schwarzlmüller; Katrin Brauckhoff; Kristian Løvås; Martin Biermann; Michael Brauckhoff Journal: BMC Surg Date: 2014-04-23 Impact factor: 2.102