@entity3 ( @entity3 ) is gaining popularity as an alternative to traditional bilateral exploration for @entity1 with @entity459 . The success of @entity3 relies on the ability of preoperative and intraoperative localization studies to guide a directed exploration for resection of a diseased gland. We hypothesize that excellent results can be achieved with @entity3 when only @entity10979 (MIBI) is used for localization. We conducted a prospective analysis of all @entity1 presenting with a biochemical diagnosis of @entity459 between January 1997 and November 2000. @entity1 meeting inclusion criteria were given a choice of @entity3 and directed exploration versus traditional bilateral exploration. Fifty @entity1 chose @entity3 . Three @entity1 who chose @entity3 had a negative MIBI, which left 47 @entity1 in the primary study group. The MIBI correctly identified a @entity3243 in 42 @entity1 (89.3%). In two other @entity1 MIBI was inaccurate; however, directed exploration was successfully converted to a bilateral exploration. Overall 44 of 47 (93.6%) @entity1 in the study group were rendered normocalcemic after the initial operation. Three @entity1 experienced persistent @entity2741 and subsequently underwent successful bilateral exploration. Including those @entity1 choosing a bilateral exploration, a total of 59 positive MIBI scans were evaluated. There were 54 true positives (positive predictive value 91.5%), and if all @entity1 had chosen a @entity3 94.9 per cent would have been successfully treated at the initial operation. Mean operative time for @entity3 was 54.6 minutes, and in 32 @entity1 (68.1%) @entity3 was performed with local anesthesia and sedation. Twenty-six @entity1 (55.3%) were discharged the same day of the procedure. There were no significant complications in any group analyzed. We conclude that @entity3 can be successfully performed on the basis of a positive MIBI scan. The present study highlighting many of the advantages of @entity3 questions the necessity of additional adjuncts such as intraoperative parathyroid hormone measurement and gamma-probe localization.

XXXX without intraoperative localization.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity459 :: ('MESH:D049950', 'Disease') :: ['primary hyperparathyroidism'] @entity2741 :: ('MESH:D006934', 'Disease') :: ['hypercalcemia'] @entity10979 :: ('MESH:D017256', 'Chemical') :: ['technetium-99m sestamibi'] @entity3 :: ('MESH:D009362', 'Disease') :: ['MIP', 'Minimally invasive parathyroidectomy'] @entity3243 :: ('MESH:D010282', 'Disease') :: ['parathyroid adenoma']
@entity3 :: (MESH:D009362,Disease) :: ['Minimally invasive parathyroidectomy']
