Preoperative localisation of impalpable breast abnormalities

Background. A proper localisation of pathological parathyroid glands is essential for a minimally invasive approach in the surgical treatment of primary hyperparathyroidism (PHP). The recent introduction of portable mini gamma-cameras (pMGCs) enabled intraoperative scintigraphic scanning. The aim of our study is to evaluate the efficacy of this new method and compare it with the preoperative localisation surveys.Methods. 20 patients were studied; they were evaluated preoperatively by neck ultrasound andTc-sestaMIBI-scintigraphy and intraoperatively with the pMGC IP Guardian 2. The results obtained from the three evaluations were compared.Results. The pMGC presented a sensitivity of 95%, a specificity of 98.89%, and a diagnostic accuracy of 98.18%, which were higher than those of preoperative ultrasound (sensitivity 55%; specificity 95%; diagnostic accuracy 87%) and scintigraphy withTc-sestaMIBI (sensitivity 73.68%; specificity 96.05%; diagnostic accuracy 91.58%).Conclusions. The pMGC can be used effectively as an intraoperative method to find the correct location of the pathological parathyroid glands. The pMGC is more reliable than the currently used preoperative and intraoperative localisation techniques.

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Thumbs up: Needle marker technique for preoperative localisation of radiolucent foreign bodies with ultrasonography

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.06.020 ◽

2020 ◽

Vol 72 ◽

pp. 546-548

Author(s):

Valliappan Muthukumar ◽

David Bodansky ◽

Ravindra Badge

Keyword(s):

Foreign Bodies ◽

Preoperative Localisation

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Preoperative localisation of parathyroid adenomas with mibi and ultrasonography: Is there an advantage of a combined approach?

International Journal of Surgery ◽

10.1016/j.ijsu.2013.06.253 ◽

2013 ◽

Vol 11 (8) ◽

pp. 634

Author(s):

Edward Ridyard ◽

Derek Siau ◽

Simon Hargreaves

Keyword(s):

Combined Approach ◽

Parathyroid Adenomas ◽

Preoperative Localisation

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PREOPERATIVE LOCALISATION OF PARATHYROID TUMOURS

The Lancet ◽

10.1016/s0140-6736(71)90488-0 ◽

1971 ◽

Vol 298 (7735) ◽

pp. 1172-1175 ◽

Cited By ~ 27

Author(s):

J.L.H O'Riordan ◽

B.E Kendall ◽

J.S Woodhead

Keyword(s):

Parathyroid Tumours ◽

Preoperative Localisation

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Segmental colectomy for bleeding diverticular disease guided by the PEEP test

Tropical Doctor ◽

10.1177/0049475517724690 ◽

2017 ◽

Vol 47 (4) ◽

pp. 355-359

Author(s):

Vijay Naraynsingh ◽

Shamir O Cawich ◽

Dale Hassranah ◽

Feisal Daniel ◽

Ravi Maharaj ◽

...

Keyword(s):

Diverticular Disease ◽

Postoperative Morbidity ◽

Total Colectomy ◽

Fresh Blood ◽

Early Completion ◽

Emergency Operations ◽

The Third ◽

Segmental Colectomy ◽

Successful Control ◽

Preoperative Localisation

Many patients with massive lower gastrointestinal (GI) haemorrhage from diverticulosis are subjected to total colectomy when preoperative localisation is unavailable. We dissected colectomy specimens and noted that there was limited retrograde reflux in most of these cases. Therefore, we sought to assess the value of a positive endoluminal erythrocyte presence (PEEP) test (presence of fresh blood in the caecum) to direct segmental colectomies in 14 patients who required emergency operations for massive lower GI haemorrhage. Overall, 13 (93%) patients who had segmental colectomy guided by the PEEP test had successful control of bleeding. There was no mortality and a 14% postoperative morbidity after segmental resections guided by the PEEP test. One patient had persistent bleeding and required a completion colectomy on the third postoperative day. We propose that the PEEP test be added to the surgical armamentarium to guide segmental resection in the absence of localisation by conventional means. However, we advocate blind total colectomy if the PEEP test is equivocal and early completion colectomy if there is significant re-bleeding.

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