Ultrasound dye-assisted parathyroidectomy (USDAP): Experience of a tertiary center: American Journal of Otolaryngology - Head and Neck Medicine and Surgery

F. Chu, G. Giugliano, M.S. Lazio, M. Proh, M. Tagliabue, E. De Fiori, M.F. Manzoni, M. Ansarin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Primary hyperparathyroidism is primarily caused by parathyroid adenoma, followed by hyperplasia and parathyroid carcinoma. In the era of minimally invasive, targeted parathyroidectomy, the main challenge remains that of distinguishing intraoperatively pathological parathyroid from normal glands and peri-thyroid fat tissue. The aim of this study is to evaluate the surgical outcomes of a novel minimally invasive technique called ultrasound-guided dye-assisted parathyroidectomy (USDAP). Methods: We perform a retrospective analysis of patients affected by parathyroid adenoma, treated with USDAP at our institution between 2014 and 2019. Data were collected on patient age and sex, tumor location and size, preoperative investigations, histopathology, perioperative complications and surgical outcomes. Results: Between January 2014 and June 2019, 43 patients underwent parathyroidectomy in our Institute. Each case was discussed by the Institutional Multidisciplinary Board. All patients undergoing thyroidectomy together with USDAP or patients undergoing USDAP under endoscopic control were excluded from the present study. The final cohort, the largest to our knowledge, consisted of 29 patients. All patients were successfully treated with USDAP and remained disease-free during follow up. In all cases, pathological parathyroid was correctly identified and removed. There was no postoperative allergic reaction, nor were there neurotoxicity complications. USDAP permitted a shortening of operative and hospitalization time. Conclusions: USDAP is an effective and safe procedure both as first line treatment and as a re-operative procedure after previous surgical failures in selected cases. © 2020 Elsevier Inc.
Original languageEnglish
JournalAm. J. Otolaryngol. Head Neck Med. Surg.
Volume41
Issue number6
DOIs
Publication statusPublished - 2020

Keywords

  • Dye
  • Parathyrodectomy
  • Ultrasound
  • USDAP
  • USDAS
  • anticoagulant agent
  • methoxy isobutyl isonitrile technetium tc 99m
  • methylene blue
  • adult
  • age
  • aged
  • anticoagulant therapy
  • Article
  • cancer diagnosis
  • cancer localization
  • cancer staging
  • cancer surgery
  • clinical article
  • cohort analysis
  • controlled study
  • female
  • follow up
  • histopathology
  • human
  • male
  • minimally invasive procedure
  • operation duration
  • parathyroid adenoma
  • parathyroidectomy
  • peroperative complication
  • peroperative echography
  • postoperative hemorrhage
  • preoperative evaluation
  • priority journal
  • retrospective study
  • sex difference
  • tertiary care center
  • thyroidectomy
  • tumor volume
  • ultrasound guided dye assisted parathyroidectomy
  • ultrasound surgery
  • adenoma
  • complication
  • computer assisted surgery
  • echography
  • hyperparathyroidism
  • length of stay
  • middle aged
  • minimally invasive surgery
  • parathyroid tumor
  • procedures
  • reoperation
  • treatment outcome
  • Adenoma
  • Adult
  • Aged
  • Female
  • Humans
  • Hyperparathyroidism
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Operative Time
  • Parathyroid Neoplasms
  • Parathyroidectomy
  • Reoperation
  • Retrospective Studies
  • Surgery, Computer-Assisted
  • Treatment Outcome
  • Ultrasonography

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