P.N. ROMASHCHENKO, N.A. MAISTRENKO, D.S. KRIVOLAPOV, D.O. VSHIVTSEV

Military Medical Academy named after S.M. Kirov, Saint-Petersburg

 Contact:

Romashchenko P.N. ― correspondent member of the Russian Academy of Sciences, MD, Professor, Head of the S.P. Fedorov Department of Faculty Surgery

Address: 6 Academik Lebedev Str., Saint-Petersburg, Russian Federation, 194044, tel. (812) 292-34-85, e-mail: romashchenko@rambler.ru

The paper presents a clinical case that reflects difficulties of primary hyperparathyroidism diagnosis, as well as an experience of usage of new methods in parathyroid surgery, which aims at increasing the degree of proofs and safety of prompt interventions. The sequence of implemented methods of laboratory and instrumental examination made it possible to accurately identify the location of parathyroid adenomas, and the implementation of the proposed surgical tactics ― to perform a surgical intervention justified in terms of volume and methodology, to avoid postoperative complications and improve the patient’s quality of life.

Key words: parathyroid surgery, primary hyperparathyroidism, intraoperative neuromonitoring, paramonitoring, fluorescent diagnostics.

(For citation: Romashchenko P.N., Maistrenko N.A., Krivolapov D.S., Vshivtsev D.O. Paramonitoring and neuromonitoring in the minimally invasive parathyroid surgery. Practical medicine. 2019. Vol. 17, № 4, P. 157-161)

REFERENCES

1. Dedov I.I., Mel’nichenko G.A., Mokrysheva N.G. et al. Primary hyperparathyroidism: clinic, diagnosis, differential diagnosis, treatment methods. Problemy endokrinologii, 2016, no. 6, pp. 40-77 (in Russ.). doi: 10.14341/probl201662640-77.
2. Yu N., Donnan P.T., Flynn R.W.V. et al. Increased mortality and morbidity in mild primary hyperparathyroid patients The Parathyroid Epidemiology and Audit Research Study (PEARS). Clinical Endocrinology, 2010, 73, pp. 30-3.
3. Khan A.A., Hanley D.A., Rizzoli R. et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int, 2017, 28 (1), pp. 1-19.
4. Dedov I.I., Mokrysheva N.G., Mirnaya S.S. et al. Epidemiology of primary hyperparathyroidism in Russia (first results from the FSI ESC database). Problemy endokrinologii, 2011, no. 3, pp. 3-10 (in Russ.).
5. Bilezikian J.P., Brandi M.L., Eastell R. et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J. Clin. Endocrinol. Metab, 2014, 99 (10), pp. 3561-9.
6. Wilhelm S.M., Wang T.S., Ruan D.T. et al. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg, 2016, 151 (10), pp. 959-968.
7. Maystrenko N.A., Romashchenko P.N., Krivolapov D.S. Intraoperative neuromonitoring in traditional and minimally invasive thyroid surgery. Sciences of Europe, 2016, vol. 2, no. 9, pp. 54-60 (in Russ.).
8. Abbaci M., De Leeuw F., Breuskin I. et al. Parathyroid gland management using optical technologies during thyroidectomy or parathyroidectomy: A systematic review. Oral Oncology, 2018, 87, pp. 186-196. doi:10.1016/j.oraloncology.2018.11.011.
9. Scattergood S., Marsden M., Kyrimi E. et al. Combined ultrasound and Sestamibi scintigraphy provides accurate preoperative localisation for patients with primary hyperparathyroidism. Ann. R. Coll. Surg. Engl, 2018, 5, pp. 1-6.
10. Van den Bos J., van Kooten L., Engelen S.M.E. et al. Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery. Head & Neck, 2018, pp. 1-9. doi:10.1002/hed.25451.