Our Summary

This study was conducted to evaluate the effectiveness of a less invasive surgical method, called minimally invasive parathyroidectomies (MIPs), to treat a condition known as primary hyperparathyroidism. The study also aimed to check the effectiveness of two imaging methods, scintigraphy and ultrasonography, in determining the exact location of the parathyroid glands before surgery.

The research was carried out at the University of Health Sciences in Istanbul, Turkey between March 2017 and December 2019. The researchers looked at the medical records of 61 patients who had undergone MIPs. They collected data on the patients’ age, gender, and calcium, parathormone, and phosphorus levels before and after the surgery.

The results showed that scintigraphy was 100% accurate in locating the parathroid glands before surgery, whereas ultrasonography failed to do so in five patients. After the surgery, the patients’ parathormone and calcium levels significantly dropped, indicating that the surgery was successful. However, four patients developed low calcium levels (hypocalcaemia) and five patients showed persistent hyperparathyroidism after three months.

In conclusion, the study found that scintigraphy is the best method to locate the parathyroid glands before surgery. If scintigraphy isn’t available, then ultrasonography can be used as an alternative. The study also confirmed that MIPs are effective in treating primary hyperparathyroidism.

FAQs

  1. What is the purpose of using imaging methods like scintigraphy and ultrasonography before parathyroidectomy?
  2. How effective was the minimally invasive parathyroidectomy (MIP) in treating primary hyperparathyroidism according to the study?
  3. What complications were observed after the surgery in the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about parathyroidectomy is to follow up regularly with blood tests to monitor calcium and parathormone levels after surgery. This can help detect any complications such as hypocalcaemia or persistent hyperparathyroidism early on and allow for prompt treatment. Additionally, maintaining a healthy diet and lifestyle can also support recovery and overall health after the procedure.

Suitable For

Patients who are typically recommended for parathyroidectomy are those diagnosed with primary hyperparathyroidism, a condition characterized by excessive production of parathyroid hormone by one or more of the parathyroid glands. Symptoms of primary hyperparathyroidism include high calcium levels in the blood, kidney stones, bone pain, and fatigue. Patients with severe symptoms or complications from the condition may be recommended for parathyroidectomy to remove the overactive parathyroid gland(s) and restore normal hormone levels.

Timeline

Timeline of a patient’s experience before and after parathyroidectomy:

Before parathyroidectomy:

  1. Patient presents with symptoms of primary hyperparathyroidism, such as fatigue, bone pain, kidney stones, and high levels of calcium in the blood.
  2. Patient undergoes diagnostic tests, including blood tests to measure calcium, parathormone, and phosphorus levels, as well as imaging tests like scintigraphy and ultrasonography to locate the parathyroid glands.
  3. Based on the test results, the decision is made to proceed with parathyroidectomy surgery.

After parathyroidectomy:

  1. Patient undergoes minimally invasive parathyroidectomy surgery.
  2. Post-surgery, the patient’s parathormone and calcium levels drop significantly, indicating successful removal of the affected parathyroid gland.
  3. Some patients may experience temporary hypocalcaemia, which may require calcium supplements.
  4. Follow-up appointments are scheduled to monitor the patient’s calcium and parathormone levels to ensure that the surgery was effective in treating primary hyperparathyroidism.
  5. Some patients may still have persistent hyperparathyroidism after the surgery, requiring further treatment or monitoring.

What to Ask Your Doctor

Some questions a patient should ask their doctor about parathyroidectomy include:

  1. What is the reason for recommending a parathyroidectomy?
  2. What are the potential risks and complications associated with the surgery?
  3. What type of anesthesia will be used during the procedure?
  4. How long will the surgery take, and what is the expected recovery time?
  5. Will I need to stay in the hospital overnight after the surgery?
  6. How will my calcium levels be monitored post-surgery?
  7. What lifestyle changes or medications may be necessary after the procedure?
  8. What is the likelihood of recurrence of hyperparathyroidism after the surgery?
  9. Are there any specific dietary restrictions I should follow post-surgery?
  10. Are there any alternative treatment options to consider before proceeding with a parathyroidectomy?

Reference

Authors: Bolukbasi H, Yılmaz S, Somuncu E, Kara Y, Bozkurt MA. Journal: J Coll Physicians Surg Pak. 2021 Apr;31(4):440-444. doi: 10.29271/jcpsp.2021.04.440. PMID: 33866731