Radioguided parathyroidectomy for hyperparathyroidism in the reoperative neck

Background. The purpose of this study was to determine if radioguided parathyroudectomy (RGP) is effective of hyperparathyroidism (HPT) in the reoperative neck. Methods. We retrospectively reviewed all patients with HPT and a history of neck surgery who underwent RGP over a 7-year period. Data arc reported as mean +/- SEM Results. We identified 110 patients with primary (n = 94), secondary (n = 7), or tertiary (n = 9) HPT who underwent 138 previous neck operations.. The average hospital stay was 0.6 +/- 0.1 days. The in and ex vivo counts obtained With the gamma. probe Were 310 +/- 26 and 130 +/- 13, respectively. The ex vivo percentage of background was 69% +/- 9%, and untually all resected parathyroids had ex vivo Counts >= 20%. After RGP 96% of patients were cured, and 5% experienced complication (all transient). Cure rates after RGP decreased as the number of previous neck operations; increased P =.002). Addilionally, reperative neck Patients with single adenomas were more likely to experience cure than patients with hyperplama (P =.0-2). Conclusion. These results illustrate that RGP is valuable in treatment of the reoperative neck. In addition, RGP allows similar lengihs of stay, efficacy, and complication rates as those reported for patients undergoing initial parathyroudectomy. (Surgery 2009;146:592-9)