Three new tools for parathyroid surgery: Expensive and unnecessary?

George Ferzli, Samir Patel, Andre Graham, Kenneth Shapiro, Hung Kei Li

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

BACKGROUND: The intraoperative quick parathyroid hormone assay, the intraoperative gamma probe, and endoscopic parathyroidectomy are three very new techniques developed to facilitate parathyroid surgery. Some hospitals do not have the necessary equipment, and many, like ours, continue to operate in the time-honored way. STUDY DESIGN: We performed a retrospective chart review of 34 such operations, done with the use of Sestamibi scans, but entirely without the newer modalities. RESULTS: Four-gland exploration was carried out on all patients. Operative times ranged from 15 to 165 minutes, with a mean of 47 minutes, and incision lengths ranged from 2 to 3 cm, with a mean of 2.8 cm. There was no mortality, no reoperation, and no vocal cord or recurrent laryngeal nerve injury. Our cure rate was 100%, as determined by a fall in postoperative calcium and parathormone levels. CONCLUSIONS: In our view, the intraoperative parathyroid hormone assay, gamma probe, and endoscopic parathyroidectomy add an entirely unnecessary cost to an operation that can be completed satisfactorily with a preoperative Sestamibi scan and a thorough four-gland exploration.

Original languageEnglish (US)
Pages (from-to)349-351
Number of pages3
JournalJournal of the American College of Surgeons
Volume198
Issue number3
DOIs
StatePublished - Mar 1 2004
Externally publishedYes

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Unnecessary Procedures
Parathyroid Hormone
Parathyroidectomy
Recurrent Laryngeal Nerve Injuries
Vocal Cords
Operative Time
Reoperation
Calcium
Costs and Cost Analysis
Equipment and Supplies
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Three new tools for parathyroid surgery : Expensive and unnecessary? / Ferzli, George; Patel, Samir; Graham, Andre; Shapiro, Kenneth; Li, Hung Kei.

In: Journal of the American College of Surgeons, Vol. 198, No. 3, 01.03.2004, p. 349-351.

Research output: Contribution to journalReview article

Ferzli, George ; Patel, Samir ; Graham, Andre ; Shapiro, Kenneth ; Li, Hung Kei. / Three new tools for parathyroid surgery : Expensive and unnecessary?. In: Journal of the American College of Surgeons. 2004 ; Vol. 198, No. 3. pp. 349-351.
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