ANALYSIS OF SAVINGS IN OPERATIVE TIME FOR PRIMARY HYPERPARATHYROIDISMUSING LOCALIZATION WITH TECHNETIUM 99M SESTAMIBI SCAN

BACKGROUND: The cost effectiveness of preoperative locaiization in cas es of primary hyperparathyroidism has not been established. We analyze d the potential savings in operative time after localization with tech netium 99m (Tc-99m) SeStamibi scan. METHODS: Thirty-three patients had localization of a solitary adenoma with (99)mTc-sestamibi. Measuremen t was made of the time required for adenomectomy, unilateral neck expl oration (UNE), unilateral neck exploration and confirmation of one con tralateral parathyroid gland (UNEC), or bilateral neck exploration (BN E). RESULTS: The total operative time in minutes was 76.4 +/- 18.8 for adenomectomy; 87.5 +/- 20.4 for UNE; 105.6 +/- 25.0 for UNEC; and 117 .9 +/- 26.7 for BNE. The time difference was significant between adeno mectomy versus UNE, UNEC, and BNE. There were also significant time di fferences between UNE versus UNEC and BNE. CONCLUSlONS: The preoperati ve localization of a solitary parathyroid adenoma may optimize operati ve time with UNE, saving approximately 30 minutes.