O62: INTRA-OPERATIVE ADJUNCTS IN MINIMALLY INVASIVE RADIO-GUIDED PARATHYROIDECTOMY AT A SPECIALIST ENDOCRINE SURGERY CENTRE

Abstract Introduction Primary Hyperparathyroidism (PH) is common cause of hypercalcaemia (0.3% the population). Minimally invasive radio-guided parathyroidectomy (MIRP) has been made possible due to advancements in pre-operative imaging i.e. sestamibi scans allowing localisation areas parathyroid hyperactivity. Method Due disagreement literature regarding which intra operative adjunct best used MIRP surgery decrease recurrence, rationale for this study examine and compare performance these adjuncts consecutive patients 1. Intra PTH assay (IOPTHA) 2. Tc-99m radio-guidance using a gamma probe 20% rule 3. Frozen section analysis. Result 45 procedures were carried out between 01/07/2018 30/10/2019. 77.8% females; mean age was 62 years (range 30 - 79). Final pathology showed that 43 cases tissue correctly removed; thyroid identified other 2 cases. positive negative (sensitivity 100%, specificity 100%). A drop IOPTHA greater than 50% found 41 but not 4 93.9%, 100% concordant with final (45/45). AUC analysis no significant difference tests (p = 0.15) around 1 section. Conclusion When frozen sections are added IOPTHA, success rate markedly improved. Using them together will greatly reduce recurrent hyperparathyroidism. Take-home message Intra-operative assays Invasive Radio-Guided Parathyroidectomy, as our incidence hyperparathyroidism thus surgery.