최소 침습적 수술을 위한 술 중 부갑상선 호르몬 측정의 유용성
Usefulness of Intraoperative Parathyroid Hormone Assay in Minimally Invasive Surgery
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초록
Background and Objectives：Intraoperative parathyroid hormone (PTH) assay has been proposed as an effective tool in minimally invasive parathyroidectomy. We evaluated its usefulness during minimally invasive parathyroidectomy. Subjects and Method：Ten patients (female 6, male 4) of primary hyperparathyroidism (8 single diseases, 2 multiple diseases) were analyzed retrospectively. We used computed tomography (CT) and 99mTc-Sestamibi (MIBI) scan for localization of parathyroid lesions preoperatively, and frozen biopsy and PTH assay at 10 (T-10), 20 (T-20) minutes after excision intraoperatively. We also compared the diagnostic sensitivity of CT and MIBI scan and intraoperative PTH. Results：All patients were treated successfully and in single disease group, diagnostic sensitivity of CT, MIBI scan were 75% and 87.5%, and that of T-10 was 75% and T-20 was 100%. In multiple disease group, diagnostic sensitivity of CT, MIBI scan were 75%, 87.5%, and that of PTH was 80%. Conclusion：Intraoperative PTH assay improves cure rate in minimally invasive parathyroidectomy. It allowed intraoperative recognition of missed parathyroid lesions by preoperative imaging study.
Abstract
Background and Objectives：Intraoperative parathyroid hormone (PTH) assay has been proposed as an effective tool in minimally invasive parathyroidectomy. We evaluated its usefulness during minimally invasive parathyroidectomy. Subjects and Method：Ten patients (female 6, male 4) of primary hyperparathyroidism (8 single diseases, 2 multiple diseases) were analyzed retrospectively. We used computed tomography (CT) and 99mTc-Sestamibi (MIBI) scan for localization of parathyroid lesions preoperatively, and frozen biopsy and PTH assay at 10 (T-10), 20 (T-20) minutes after excision intraoperatively. We also compared the diagnostic sensitivity of CT and MIBI scan and intraoperative PTH. Results：All patients were treated successfully and in single disease group, diagnostic sensitivity of CT, MIBI scan were 75% and 87.5%, and that of T-10 was 75% and T-20 was 100%. In multiple disease group, diagnostic sensitivity of CT, MIBI scan were 75%, 87.5%, and that of PTH was 80%. Conclusion：Intraoperative PTH assay improves cure rate in minimally invasive parathyroidectomy. It allowed intraoperative recognition of missed parathyroid lesions by preoperative imaging study.
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