Minimally invasive (less damaging) surgeries are performed using ultrasonography or radioactive material, or both. 1.5-2 cm just above the diseased parathyroid gland in the location determined by ultrasonography or scintigraphy in the neck (during surgery or before). An incision is made. Since the incision is small, only the diseased parathyroid gland is removed and other parathyroid glands are usually not examined. For this reason, rapid parathyroid hormone determination is performed during surgery to determine the adequacy of the surgery.
Rapid parathyroid hormone determination is a method that gives results within 18-20 minutes. In the measurements taken while the patient is undergoing surgery and 10 minutes after the parathyroid adenoma is removed, the parathormone value must have decreased to at least 50% of the first measurement in the second measurement. If a decrease of 50% or more is achieved, this indicates that surgery has been performed adequately in 87-95% of single gland adenomas. However, if there is adenoma in more than one gland, sometimes this value may still decrease by 50% or more. If this decrease is not achieved, it should be investigated whether there is another adenoma. The same side of the neck should be evaluated first and, if necessary, the opposite side during surgery.
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