Utility Of Frozen Section Versus IOPTH In Parathyroid Surgery
Keywords:
frozen, parathyroid, chemical
Abstract
Introduction: Parathyroid surgeries are becoming less extensive procedures, with reduced hospital stay. The use of intraoperative frozen section help the surgeon in identifying the pathology, thereby determining the nature of surgery. Aim: To study the utility of frozen section in comparison to chemical frozen section in our set up Materials and methods: Data was collected from records of department of Pathology during a period of 3 years. Only those cases were included in which the patient had undergone parathyroidectomy, with specimen being sent for frozen section and intra-operative parathyroid hormone (IOPTH) simultaneously. Results: Frozen section diagnosis was concordant in 11/15 (73%) cases. Significant percentage drop in IOPTH was seen in 13/15 (86%) cases. We found frozen section useful in identifying parathyroid when there were multiple neck swellings. Conclusion: The utility of frozen section in parathyroid surgery is diminishing and it is being replaced by better and more accurate biochemical assays.References
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3. Agarwal G, Barraclough BH, Reeve TS, Delbridge LW. Minimally invasive parathyroidectomy using the “focused” lateral approach. II. Surgical technique. ANZ J Surg. 2002;72:147-51.
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5. Van der Walt J. Pathology of the parathyroid glands. Diagn Histopathol. 2012;18:221-33.
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7. Coan KE, Yen TWF, Carr AA, Bullock M, Colon-Franco JM, Evans DB,et al. Intraoperative ex vivo parathyroid aspiration: A point-of-care test to confirm parathyroid tissue. Surgery. 2016;160(4):850-7.
8. Iacobone M, Scarpa M, Lumachi F, Favia G (2005) Are frozen sections useful and cost-effective in the era of intraoperative qPTH assays? Surgery 138:1159–1164.
9. Osamura RY and Hunt JL. Virchows Arch 2008;453:433-40.
10. Dewan AK, Kapadia SB, Hollenbeak CS, Stack BC Jr. Is routine frozen section necessary for parathyroid surgery? Otolaryngol 2005;133:857-62.
11. Tampi C, Chavan N and Parikh D. Intraoperative parathyroid hormone assay-cutting the Gordian knot - Indian J Endocrinol Metab. 2014 Mar-Apr; 18(2): 210–212.
2. Guarda LA. Rapid intraoperative parathyroid hormone testing with surgical pathology correlations: the "chemical frozen section". Am J Clin Pathol. 2004;122:704-12.
3. Agarwal G, Barraclough BH, Reeve TS, Delbridge LW. Minimally invasive parathyroidectomy using the “focused” lateral approach. II. Surgical technique. ANZ J Surg. 2002;72:147-51.
4. Khalid AN, Hollenbeak CS, Higginbotham BW and Stack BC. Accuracy and definitive interpretation of preoperative technetium 99m sestamibi imaging based on the discipline of the reader. Head Neck. 2009;31:576–82.
5. Van der Walt J. Pathology of the parathyroid glands. Diagn Histopathol. 2012;18:221-33.
6. Farrag T, Weinberger P, Seybt M, Terris DJ. Point-of-care rapid intraoperative parathyroid hormone assay of needle aspirates from parathyroid tissue: a substitute for frozen sections. Am J Otolaryngol 2011;32:574-7.
7. Coan KE, Yen TWF, Carr AA, Bullock M, Colon-Franco JM, Evans DB,et al. Intraoperative ex vivo parathyroid aspiration: A point-of-care test to confirm parathyroid tissue. Surgery. 2016;160(4):850-7.
8. Iacobone M, Scarpa M, Lumachi F, Favia G (2005) Are frozen sections useful and cost-effective in the era of intraoperative qPTH assays? Surgery 138:1159–1164.
9. Osamura RY and Hunt JL. Virchows Arch 2008;453:433-40.
10. Dewan AK, Kapadia SB, Hollenbeak CS, Stack BC Jr. Is routine frozen section necessary for parathyroid surgery? Otolaryngol 2005;133:857-62.
11. Tampi C, Chavan N and Parikh D. Intraoperative parathyroid hormone assay-cutting the Gordian knot - Indian J Endocrinol Metab. 2014 Mar-Apr; 18(2): 210–212.
Published
2018-12-17
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Section
Original Article
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