Endocrine Abstracts

Objective: In primary hiperparathyroidism (PHPT), increasing the number of patients treated by focused parathyroidectomy should be the main objective of pre-surgical imaging modalities. Suspicious or negative imaging results do not always mean multiglandular disease, most of the patients may single adenoma and therefore these patients may still benefit from focused parathyroidectomy.

Methods: Retrospectively, we analyzed the data of 65 patients with PHPT with suspicious or negative sestamibi scans who admitted at a tertiary reference center between January 2013 and December 2016. We excluded patients who had history of chronic renal failure, renal transplant and multiple endocrine neoplasia. All patients underwent an endocrinologist operated ultrasonographic examination and parathyroid fine needle aspiration wash-out procedure.

Results: Of the 65 patients, 23 patients had nodular guatr disease. Fifty-four patients had positive parathormone (PTH) wash-out results. A total of 43 patients underwent surgery. Of the 43 patients, four patients had redo-surgery. Of the operated patients, 40 had positive parathormone wash-out results and had successful focused surgery. All of the patients with redo-surgery had positive parathormone wash-out results and successfully re-operated. Three patients with negative PTH wash-out results, two of them had successful bilateral neck exploration, but a patient’s operation was not successful although bilateral neck exploration.

Conclusion: Endocrinologist operated US and PTH wash-out increases the number and success of focused surgery. Especially, patients with redo-surgery may benefit from this procedure.