Current status of surgical techniques for parathyroidectomy for untreated primary hyperparathyroidism: is the technology worth it?

摘要

Primary hyperparathyroidism (PHPT) OCCUrS in 20 per 100,000 patient-years and is three to four times more common in women than men. In the United States, roughly 100,000 new cases are diagnosed annually. PHPT is caused predominantly by a single abnormally functioning gland (85 to 90%) with the remaining 10 to 15 per cent resulting from multiple gland involvement. The major advance in the treatment of PHPT has been the introduction of reliable new technologies that have improved the preoperative localization of abnormal gland(s) and allow most parathyroid surgery to be less extensive and more precise. These new technologies include the technetium-99m (Tc-99m) sesta-mibi scan, the gamma probe, and the intraoperative parathyroid hormone (PTH) assay (IOPTH).