USEFULNESS OF PREOPERATIVE LOCALIZATION S TUDIES IN THE SURGERY OF PRIMARY HYPERPARATHYROIDISM

BACKGROUND: The aim of the study was to assess whether preoperative lo calization is helpful in improving the outcome of initial surgery of p rimary hyperparathyroidism (PHPT). PATIENTS AND METHODS: Retrospective review of 100 patients treated surgically for PHPT, In 30 cases (grou p 1) 3 or 4 localization studies were performed from the following: ul trasonography (US), computed tomography (CT), thallium-technetium subs traction scintigraphy (TTS), and technetium 99m-sestamibi scanning (MI BI). Thirty one patients (group II) were operated without previous loc alization. Sensitivity and false localization rate of image studies we re calculated, and cure and surgical complication rates were compared in both groups. RESULTS: Both groups were similar in mean age (56.2 vs 52.2 years), serum calcium (12.3 vs 12.1 mg/dl), intact PTH levels (3 04 vs 254 pg/ml), pathology (26 adenomas, 3 hyperplasias and 1 carcino ma vs 27 adenomas, 3 hyperplasias and 1 carcinoma) and additional clin ical and biochemical data. The highest sensitivity tecnique was for MI BI (62.5%). The highest false localization rate was for CT (27.6%). No significative differences were found between groups I and II for the cure rate (90% vs 87.1%) or surgical complications (3.3% vs 3.2%), CON CLUSIONS: In our series of patients with primary hyperparathyroidism p reoperative localization studies display low sensitivity and estimable false localization rate, These techniques increment cost and don't im prove sucess rate of initial surgery in PHPT. Therefore, we believe it s performance controversial.