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Feasibility of focused parathyroidectomy in developing countries-a scoping review
Kapil Rugnath1, Suman Mewa Kinoo1,2
1Department of General Surgery, King Edward VIII Hospital, Durban, South Africa.
Gland Surgery
|July 17, 2024
Summary
Focused parathyroidectomy (FP) is feasible in developing nations. Accurate preoperative localization and high cure rates (96.4%) demonstrate FP
Area of Science:
- Endocrine Surgery
- Surgical Oncology
- Global Health
Background:
- Primary hyperparathyroidism treatment typically involves parathyroidectomy.
- Minimally invasive focused parathyroidectomy (FP) requires preoperative localization.
- FP feasibility in developing countries remains under-demonstrated.
Purpose of the Study:
- To assess the feasibility of focused parathyroidectomy (FP) in developing countries.
- To evaluate preoperative localization techniques and cure rates for FP in these settings.
Main Methods:
- A scoping review of literature from 2007 onwards was conducted.
- Included studies focused on FP, preoperative localization, and economic impact in developing countries.
- 18 articles from seven developing countries met the inclusion criteria.
Main Results:
- Preoperative localization accuracy: 75.5% for ultrasound, 85.7% for 99mTc sestamibi.
- 1,202 patients underwent FP, with an overall cure rate of 96.4%.
- FP with intraoperative adjuncts showed a higher cure rate (99.2%) than without (95.3%).
Conclusions:
- Focused parathyroidectomy is a feasible surgical option in developing countries.
- Accurate preoperative localization is achievable and crucial for successful FP.
- High cure rates support the adoption of FP in resource-limited settings.
