核医学と放射線治療

Radio-guided Surgery of a Patient with Secondary Hyperparathyroidism: The Clinical Impact on the Duration of Surgery in Renal Failure Patient

Abstract

Pelin Ozcan Kara, Emel Ceylan Günay, Kenan Turgutalp and Ahmet Dag

Secondary hyperparathyroidism is consequent to a chronic hypocalcaemic condition that can be caused primarily by renal failure. As a result of continuous stimulus to produce and secrete PTH induces parathyroid gland hyperplasia. In this case report, we present a chronic renal failure patient with high parathyroid hormon level suspected for secondary hyperparathyroidism. According to the parathyroid scan findings four glands were demonstrated concordant with parathyroid pathology and the patient was operated with intra- operative gamma probe in a very short time. Radio-guided surgery of this renal failure patient by using intra-operative gamma probe for excision of hyperplastic parathyroid glands and hereby shortening the surgery time, provided a positive impact of renal residual function of this dialysis patient. Although, radioguided surgery with minimal invasive surgery is commonly recommended for primary hyperparathyroidism with single adenoma, we recomment radioguided surgery of hyperplastic parathyroid glands especially in renal failure patients for maintaining renal residual function.