The trend toward limited exploration for @entity459 (1 degrees HPT) has stemmed from advances in sestamibi scanning, gamma probe technology, and intraoperative parathyroid hormone monitoring (iPTH). Prior to widespread application, directed parathyroidectomy must be shown to meet the high standards of conventional cervical exploration. In this prospective, nonrandomized trial, results of parathyroidectomy utilizing the gamma probe, iPTH, or neither technique were evaluated. Altogether, 150 @entity1 underwent parathyroidectomy utilizing the gamma probe (n = 50), iPTH (n = 50), or neither technique (n = 50). Each group was evaluated for operating time, length of hospitalization, cure rate, morbidity, mortality, and cost. A telephone survey was conducted with 25 @entity1 in each group (n = 75) to address @entity1 satisfaction. The gamma probe localized the abnormal gland in 66% of @entity1 and confirmed cure intraoperatively in 84%. In the iPTH group, a more than 50% decrease from baseline occurred in 98%. The mean operating times were 76, 84, and 90 minutes, respectively (p = 0.16); and the mean length of hospitalization was 1 day. The biochemical cure rates were 98%, 100%, and 96%, respectively (p = 0.17). Total costs were  4476,  3918, and  3905, respectively. A total of 96% of @entity1 in all three groups were "very satisfied" with their surgical procedure. @entity4629 utilizing the gamma probe or iPTH assay does not significantly alter the operating time, length of hospitalization, cure rate, morbidity, mortality, or @entity1 satisfaction when compared to conventional exploration in our practice. The probe is more expensive and was not a consistently reliable tool for localizing parathyroid pathology. @entity461 monitoring reliably predicts cure intraoperatively.

Will directed parathyroidectomy utilizing the gamma probe or intraoperative parathyroid hormone assay replace bilateral cervical exploration as the preferred operation for XXXX ?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity459 :: ('MESH:D049950', 'Disease') :: ['primary hyperparathyroidism'] @entity4629 :: ('MESH:D051556', 'Disease') :: ['Directed parathyroidectomy'] @entity461 :: ('5741', 'Gene') :: ['PTH']
@entity459 :: (MESH:D049950,Disease) :: ['primary hyperparathyroidism']
