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The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient

INTRODUCTION: Parathyroid surgery for renal hyperparathyroidism (RHPT) is indicated when patients have a progressive disease despite optimal medical therapy. The success of total parathyroidectomy in RHPT lies in accurate localization and excision of all PTGs. Recently, surgeon-performed ultrasound...

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Main Authors: Lai, J. H., Mahno, Noor Ezmas, Md Latar, Nani Harlina, Muhammad, Rohaizak, Abdullah Suhaimi, Shahrun Niza
Format: Article
Language:English
English
Published: IIUM Press 2022
Subjects:
RD Surgery
Online Access:http://irep.iium.edu.my/105568/7/105568_The%20accuracy%20of%20surgeon-performed.pdf
http://irep.iium.edu.my/105568/8/105568_The%20accuracy%20of%20surgeon-performed%20_Scopus.pdf
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https://journals.iium.edu.my/kom/index.php/imjm/article/view/1833
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spelling my.iium.irep.1055682023-07-17T07:34:10Z http://irep.iium.edu.my/105568/ The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient Lai, J. H. Mahno, Noor Ezmas Md Latar, Nani Harlina Muhammad, Rohaizak Abdullah Suhaimi, Shahrun Niza RD Surgery INTRODUCTION: Parathyroid surgery for renal hyperparathyroidism (RHPT) is indicated when patients have a progressive disease despite optimal medical therapy. The success of total parathyroidectomy in RHPT lies in accurate localization and excision of all PTGs. Recently, surgeon-performed ultrasound (SPU) has been increasingly used for the preoperative localization of PTGs in the intent of focused approach and reduce morbidity. Thus, we conducted a prospective observational single-center study to determine the accuracy of SPU for PTG localization in RHPT and the factors affecting its accuracy. MATERIALS AND METHODS: This is a prospective, observational, single-center study conducted in University Kebangsaan Malaysia Medical Centre between March 2018 and March 2019. The patients’ preoperative demography, clinical data, and relevant blood laboratory results, including calcium, phosphate, alkaline phosphatase, and intact parathyroid hormone, were recorded. Preoperative USG and surgery were performed by the same endocrine surgery consultant. RESULTS: SPU localization had an overall accuracy of 78.1%, sensitivity of 81.0%, and specificity of 30.0% with a positive predictive value of 94.8% and a negative predictive value of 10.5%. The SPU gland localization rate was significantly higher in patients without goiter (median=0.88, IQR=0.63–1.00) than in those with goiter (median=0.50, IQR=0.25–0.75) (p=0.028). CONCLUSIONS: SPU localization of the PTG in RHPT had an accuracy comparable with that in previous literature with the additional advantage of identifying concurrent unknown thyroid nodules. Considering the high prevalence of concomitant nodular thyroid disease in our RHPT population, we advocate the routine use of preoperative neck ultrasound for RHPT patients undergoing parathyroid surgery. IIUM Press 2022-04-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/105568/7/105568_The%20accuracy%20of%20surgeon-performed.pdf application/pdf en http://irep.iium.edu.my/105568/8/105568_The%20accuracy%20of%20surgeon-performed%20_Scopus.pdf Lai, J. H. and Mahno, Noor Ezmas and Md Latar, Nani Harlina and Muhammad, Rohaizak and Abdullah Suhaimi, Shahrun Niza (2022) The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient. IIUM Medical Journal Malaysia, 21 (2). pp. 88-94. ISSN 1823-4631 E-ISSN 2735-2285 https://journals.iium.edu.my/kom/index.php/imjm/article/view/1833 10.31436/imjm.v21i2
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
topic RD Surgery
spellingShingle RD Surgery
Lai, J. H.
Mahno, Noor Ezmas
Md Latar, Nani Harlina
Muhammad, Rohaizak
Abdullah Suhaimi, Shahrun Niza
The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient
description INTRODUCTION: Parathyroid surgery for renal hyperparathyroidism (RHPT) is indicated when patients have a progressive disease despite optimal medical therapy. The success of total parathyroidectomy in RHPT lies in accurate localization and excision of all PTGs. Recently, surgeon-performed ultrasound (SPU) has been increasingly used for the preoperative localization of PTGs in the intent of focused approach and reduce morbidity. Thus, we conducted a prospective observational single-center study to determine the accuracy of SPU for PTG localization in RHPT and the factors affecting its accuracy. MATERIALS AND METHODS: This is a prospective, observational, single-center study conducted in University Kebangsaan Malaysia Medical Centre between March 2018 and March 2019. The patients’ preoperative demography, clinical data, and relevant blood laboratory results, including calcium, phosphate, alkaline phosphatase, and intact parathyroid hormone, were recorded. Preoperative USG and surgery were performed by the same endocrine surgery consultant. RESULTS: SPU localization had an overall accuracy of 78.1%, sensitivity of 81.0%, and specificity of 30.0% with a positive predictive value of 94.8% and a negative predictive value of 10.5%. The SPU gland localization rate was significantly higher in patients without goiter (median=0.88, IQR=0.63–1.00) than in those with goiter (median=0.50, IQR=0.25–0.75) (p=0.028). CONCLUSIONS: SPU localization of the PTG in RHPT had an accuracy comparable with that in previous literature with the additional advantage of identifying concurrent unknown thyroid nodules. Considering the high prevalence of concomitant nodular thyroid disease in our RHPT population, we advocate the routine use of preoperative neck ultrasound for RHPT patients undergoing parathyroid surgery.
format Article
author Lai, J. H.
Mahno, Noor Ezmas
Md Latar, Nani Harlina
Muhammad, Rohaizak
Abdullah Suhaimi, Shahrun Niza
author_facet Lai, J. H.
Mahno, Noor Ezmas
Md Latar, Nani Harlina
Muhammad, Rohaizak
Abdullah Suhaimi, Shahrun Niza
author_sort Lai, J. H.
title The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient
title_short The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient
title_full The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient
title_fullStr The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient
title_full_unstemmed The accuracy of surgeon-performed preoperative parathyroid ultrasound localization for Renal Hyperparathyroidism patient
title_sort accuracy of surgeon-performed preoperative parathyroid ultrasound localization for renal hyperparathyroidism patient
publisher IIUM Press
publishDate 2022
url http://irep.iium.edu.my/105568/7/105568_The%20accuracy%20of%20surgeon-performed.pdf
http://irep.iium.edu.my/105568/8/105568_The%20accuracy%20of%20surgeon-performed%20_Scopus.pdf
http://irep.iium.edu.my/105568/
https://journals.iium.edu.my/kom/index.php/imjm/article/view/1833
_version_ 1772810694198034432
score 13.211869

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