MINIMALLY INVASIVE RADIOGUIDED PARATHYROIDECTOMY

Autori:

KSENIJA KOVAČIĆ, MIRA MISJAK, VLADIMIR PETRIC, SUNČICA NOVOSEL, ZVONKO KUSIĆ

Sažetak
Paratiroidektomija vođena sondom tehnika je koja omogućava izravan pristup na patološki izmijenjenu paratiroidnu žlijezdu koja je znatno aktivnija od okoline. Zahvat je stoga minimalno invazivan i kraći od standardnoga. U Klinici za onkologiju i nuklearnu medicinu već neko vrijeme postoji takva sonda, pa je zahvaljujući dobroj suradnji s Internom i ORL klinikom, 16. travnja 2002. godine izvršena prva takva operacija u Hrvatskoj. Do sada je tom metodom operirano 15 bolesnika. Svi bolesnici imali su dokazani primarni hiperparatiroidizam. Dva sata prije operacije injiciran im je u venu 99m-Tc-SESTAMIBI (700 MBq). Snimanje je obavljeno 10 i 80 minuta kasnije. Nakon toga bolesnik odlazi u operacijsku dvoranu. U radu iznosimo svoja prva iskustva u primjeni ove metode, kao i zapažanja u vezi s odabirom bolesnika.
Summary

Summary. The use of a hand-held gamma probe during the operation allows a direct approach to the parathyroid adenoma, which is more active than the thyroid. This procedure is significantly less morbid and can be performed in shorter time than standard neck exploration. Hand-held gamma probe already existed at the Department of Oncology and Nuclear Medicine. As a result of a very good cooperation with Department of Internal medicine and Department of Othorhinolaryngology, for the first time in our country minimally invasive radioguided parathyroidectomy was performed on April 16th, 2002. Until now, 15 patients with primary hyperparathyroidism underwent this type of operation. 700 MBq 99m-Tc-SESTAMIBI was injected two hours before the planned operative procedure. Preoperative scintigraphy was performed 10 and 80 minutes after the administra- tion of radiopharmaceutical.This study deals with our first experience of intra-operative localization of parathyroid adenomas using a hand-held gamma probe, as well as our observations concerning the selection of the patients.

Volumen: 9-10, 2004

Liječ Vjesn 2004;126:250–253

Ksenija Kovačić, MIRA MISJAK, SUNČICA NOVOSEL, VLADIMIR PETRIC, Zvonko Kusić

Preuzmi PDF