Focussed Parathyroidectomy

Abstract

BACKGROUND: Focussed parathyroidectomy is defined as a surgical approach that preoperatively aims to identify and remove a single enlarged parathyroid gland while eliminating the unnecessary dissection of multiple glands or a bilateral neck exploration.

OBJECTIVE: To assess the feasibility, safety and adequacy of focussed parathyroidectomy approach using preoperative scans.

MATERIAL AND METHODS: we conducted a retrospective study from 2015 to 2018 and a prospective study thereafter on 106 patients who underwent focussed parathyroidectomy.

RESULTS:  In our study  mean age of our patients was 40 years.  50% of patients belong to the age group of 30-44 years with a female : male ratio of 2.9:1. Majority of the patients (50.9%) presented with nephrolithiasis or nephrocalcinosis.  98% of our cases were successfully treated without any major intraoperative or postoperative complications.5 (4.7%) patients developed transient hypocacemia and all of them managed with oral calcium supplementation.Their were only 2 cases(1.8%) of recurence. No case of parathyroid carcinoma was detected.Average operative time was 30-60 min.Low postoperative pain, shorter hospital stay and better cosmesis are the additional advantages seen

CONCLUSION: we conclude from our study that focussed parathyroidectomy is feasilbe,safe and effective in patients of solitary parathyroid adenomas using preoperative imaging studies provided that proper selection of the patients is done