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

BACKGROUND: The cost effectiveness of preoperative locaiization in cases of primary hyperparathyroidism has not been established. We analyzed the potential savings in operative time after localization with technetium 99m (Tc-99m) SeStamibi scan. METHODS: Thirty-three patients had localization of a solitary adenoma with (99)mTc-sestamibi. Measurement was made of the time required for adenomectomy, unilateral neck exploration (UNE), unilateral neck exploration and confirmation of one contralateral parathyroid gland (UNEC), or bilateral neck exploration (BNE). 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 adenomectomy versus UNE, UNEC, and BNE. There were also significant time differences between UNE versus UNEC and BNE. CONCLUSlONS: The preoperative localization of a solitary parathyroid adenoma may optimize operative time with UNE, saving approximately 30 minutes.