ECE2022 Eposter Presentations Calcium and Bone (114 abstracts)
Bilateral neck exploration is comparable to preoperative visualization methods in searching for parathyroid adenomas on the neck
Dmitrii Buzanakov 1,2 , Arseny Semenov 1,2 , Ilya Sleptsov 1,2 , Roman Chernikov 1 , Konstantin Novokshonov 1 , Yuliya Karelina 1 , Anna Uspenskaya 1 , Nataliya Gorskaya 1 , Svetlana Alekseyeva 1 , Nataliya Timofeyeva 1 , Igor Chinchuk 1 , Elisey Fedorov 1 , Yuriy Malyugov 1 , Dina Rebrova 1 , Shamil Shikhmagomedov 1 , Ilya Sablin 1 , Timur Dzhumatov 2 , Mikhail Lyubimov 1 , Alexander Pushkaruk 1 , Kseniya Gerasimova 1 , Anna Zolotukho 2 & Alexander Bubnov 1
1Saint Petersburg State University Hospital, Saint Petersburg, Russian Federation; 2Saint Petersburg State University, Faculty of Medicine, Saint Petersburg, Russian Federation.
Background Undetected multiglandular disease (MGD) is a leading cause of persistent primary hyperparathyroidism after surgical treatment. There is still a number of clinically significant parathyroid adenomas that remain unseen preoperatively.
Materials and methods A retrospective cohort study was conducted in order to reveal factors associated with risk of MGD. 810 cases of pHPT patients who had received primary surgical treatment at SPBU Hospital in 2017–2018 were included. All the patients had at least one preoperative visualization study (neck ultrasound performed by a surgeon) before the operation. In 537 cases two studies (additional 4D CT or MIBI scan) were performed and 164 cases had all three studies. A surgeon was free to choose whether perform bilateral neck exploration or not. Data analysis was performed in R.
Results. Number of patients with at least one adenoma that was not localized preoperatively with no less than two studies performed was 46 (26 single adenomas and 20 complementary). In 30 cases BNE was performed resulting in finding an unseen adenoma in 27 cases (90%). US, CT and MIBI sensitivity values were found to be 83.5%, 92.3% and 75.1% respectively. MGD rate accounted for 6.17% (50 cases). 43 cases of persistent disease after surgery were reported, 25 of them were caused by MGD. Negative predictive value of MGD for different combinations of studies with concordant results (US+MIBI, US+CT and US+CT+MIBI) did not differ significantly and was 96.95%, 97.4% and 97.7% respectively. Logistic regression model was performed, showing that independent negative US, negative CT or negative MIBI were not statistically significant in predicting risk of MGD, as well as age and body mass index.
Conclusion. Bilateral neck exploration added to a routine parathyroidectomy is helpful for discovering an unsuspected MGD case.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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