The Application of Radio-Guided Occult Lesion Localization (ROLL) to the Minimal Invasive Parathyroidectomy: Our Experience

Loufopoulos PD1*, Miliaras S1 , Tsoulfas G1 , Iakovou I2 and Papadopoulos V1

1st Surgical Clinic, Aristotle University of Thessaloniki, Greece 2 3rd Clinical Laboratory of Nuclear Medicine, Aristotle University of Thessaloniki, Greece

^*Correspondance to: Loufopoulos PD 

 PDF  Full Text DOI: 10.25107/2474-1647.3208

Abstract

Introduction: Minimal Invasive Parathyroidectomy (MIP) has gained more popularity in recent years, compared to bilateral neck exploration, which was traditionally used in the past. The purpose of our study was to analyze the technical feasibility, effectiveness and safety of Radio-guided Occult Lesion Localization (ROLL) as an adjuvant tool in the surgical excision of parathyroid adenomas. Materials and Methods: The study was conducted in the 1st Surgical Clinic of Aristotle University of Thessaloniki, Greece during the period between December 2016 and October 2020. Fifty patients with primary hyperparathyroidism due to a single parathyroid adenoma, which was detectable preoperatively with ultrasonography, were included in the study. All patients were subjected to minimal invasive parathyroidectomy using the ROLL technique. Patient demographics, pre-/ postoperative Parathyroid Hormone (PTH) and calcium levels, complications related to the injection of the radiotracer, leakage of the radiotracer into the surrounding tissues, excision efficacy, operative time, postoperative complications and length of hospitalization were all recorded. Results: The preoperatively marked lesion was successfully identified intraoperatively and excised in all patients, including those with negative scintigraphy and previous operations in the neck. Postoperative PTH and calcium levels were reduced. None of the patients exhibited complications related to the preoperative intralesional infusion of the radiotracer. Leakage of the radiotracer was observed in seven patients. Operation time and length of hospitalization were short. Conclusion: The application of ROLL in parathyroid surgery is technically safe, effective and could be used as an excellent collateral navig

Keywords

Primary hyperparathyroidism; Parathyroid adenoma; Radio-guided occult lesion localization; Gamma camera probe; Minimal invasive parathyroidectomy

Cite the article

Loufopoulos PD, Miliaras S, Tsoulfas G, Iakovou I, Papadopoulos V. The Application of Radio-Guided Occult Lesion Localization (ROLL) to the Minimal Invasive Parathyroidectomy: Our Experience. Clin Surg. 2021; 6: 3208..