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Related Experiment Videos

Is routine frozen section necessary for parathyroid surgery?

Anil K Dewan1, Silloo B Kapadia, Christopher S Hollenbeak

  • 1Department of Pathology, Pennsylvania State University College of Medicine, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 20, 2005
PubMed
Summary

Experienced surgeons can often forgo routine frozen section (FS) analysis during parathyroidectomy. Gross examination (GE) by surgeons and pathologists is a cost-effective method for identifying parathyroid tissue.

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Area of Science:

  • Endocrinology
  • Surgical Pathology
  • Surgical Oncology

Background:

  • Parathyroidectomy necessitates accurate identification and removal of abnormal parathyroid glands.
  • Pathologists confirm parathyroid tissue presence intraoperatively.
  • Advancements like radionuclide scanning and rapid parathyroid hormone assays question the necessity of routine frozen section (FS).

Purpose of the Study:

  • To evaluate the need for routine FS in parathyroid tissue identification during parathyroidectomy.
  • To assess the accuracy and cost-effectiveness of gross examination (GE) versus FS.

Main Methods:

  • Analysis of 50 consecutive parathyroidectomies performed by a single surgeon.
  • Recording of surgeon and pathologist diagnoses on GE.
  • Performance of cytologic smears and FSs.

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  • Inclusion of a cost analysis.

    • Main Results:

    • Concordance between surgeon and pathologist diagnoses on GE in all 50 cases.
    • Incorrect gross identification occurred in 6% (3) of cases.
    • GE demonstrated cost-effectiveness for parathyroid tissue identification.

    Conclusions:

    • Routine FS examination may not be necessary for experienced parathyroid surgeons.
    • The decision to omit intraoperative FS should consider potential misdiagnosis and repeat surgery implications.