Successful Localization of Abnormal Parathyroid Gland Using Ultrasound-Guided Methylene Blue Dye Injection in the Reoperative Neck
Tóm tắt
Persistent or recurrent hyperparathyroidism is a challenging problem for endocrine surgeons. The aim of this study was to review our experience using ultrasound-guided (US-G) methylene blue dye injection for the localization and removal of abnormal parathyroid glands in patients having primary hyperparathyroidism and previous neck surgery. Between January 2012 and May 2013, six consecutive patients with primary hyperparathyroidism (PHPT) and previous neck surgery underwent focused parathyroidectomy with the use of US-G methylene blue dye injections to localize the presumed parathyroid adenoma were included in the study. We analyzed the data of six patients who underwent reoperative parathyroid surgery using US-G methylene blue dye injection retrospectively. The dye injection was performed just prior to surgery. All patients were successfully treated for their hyperparathyroidism which was confirmed by at least 50 % drop in intraoperative parathormone level 10 min after resection. There were no complications related with US-G dye injection or with surgery. US-G methylene blue dye injection is a cheap, safe, and effective method for localization of diseased parathyroid glands and guiding surgery in the reoperative neck.
Tài liệu tham khảo
Triponez F, Poder L, Zarnegar R, Goldstein R, Roayaie K, Feldstein V, Lee J, Kebebew E, Duh QY, Clark OH (2006) Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments: a safe technique for small, nonpalpable recurrent disease. J Clin Endocrinol Metab 91(12):4943–4947
Tükenmez M, Erbil Y, Barbaros U, Dural C, Salmaslioglu A, Aksoy D, Mudun A, Ozarmağan S (2007) Radio-guided nonpalpable metastatic lymph node localization in patients with recurrent thyroid cancer. J Surg Oncol 96(6):534–538
Kang TW, Shin JH, Han BK, Ko EY, Kang SS, Hahn SY, Kim JS, Oh YL (2009) Preoperative ultrasound-guided tattooing localization of recurrences after thyroidectomy: safety and effectiveness. Ann Surg Oncol 16(6):1655–1659
Terzioğlu T, Senyurek YG, Tunca F, Türkmen C, Mudun A, Salmaslıoglu A, Sanlı S, Bircan H, Demirkol O, Tezelman S (2010) Excision efficiency of radioguided occult lesion localization in reoperative thyroid and parathyroid surgery. Thyroid 20(10):1271–1278
Sippel RS, Elaraj DM, Poder L, Duh QY, Kebebew E, Clark OH (2009) Localization of recurrent thyroid cancer using intraoperative ultrasound-guided dye injection. World J Surg 33(3):434–439
Harari A, Sippel RS, Goldstein R, Aziz S, Shen W, Gosnell J, Duh QY, Clark OH (2012) Successful localization of recurrent thyroid cancer in reoperative neck surgery using ultrasound-guided methylene blue dye injection. J Am Coll Surg 215(4):555–561
Perrier ND, Ituarte P, Kikuchi S, Siperstein AE, Duh QY, Clark OH, Gielow R, Hamill T (2000) Intraoperative parathyroid aspiration and parathyroid hormone assay as an alternative to frozen section for tissue identification. World J Surg 24(11):1319–1322
Solorzano CC, Evans DB (2007) Same-day ultrasound guidance in reoperations for locally recurrent papillary thyroid cancer. Surgery 142(6):973–975
Chao TC, Jeng LB, Lin JD, Chen MF (1997) Reoperative thyroid surgery. World J Surg 21(6):644–647
Candell L, Campbell MJ, Shen WT, Gosnell JE, Clark OH, Duh QY (2014) Ultrasound-guided methylene blue dye injection for parathyroid localization in the reoperative neck. World J Surg 38(1):88–91
Grant CS, van Heerden JA, Charboneau JW, James EM, Reading CC (1986) Clinical management of persistent and/or recurrent primary hyperparathyroidism. World J Surg 10(4):555–565
Akerström G, Rudberg C, Grimelius L, Johansson H, Lundström B, Rastad J (1992) Causes of failed primary exploration and technical aspects of reoperation in primary hyperparathyroidism. World J Surg 16(4):565–568
Sugino K, Ito K, Nagahama M, Kitagawa W, Shibuya H, Ohkuwa K, Yano Y, Ito K (2010) Minimally invasive surgery for primary hyperparathyroidism with or without intraoperative parathyroid hormone monitoring. Endocr J 57(11):953–958
Patel HP, Chadwick DR, Harrison BJ, Balasubramanian SP (2012) Systemic review of intravenous methylene blue in parathyroid surgery. Br J Surg 99(10):1345–1352