Role of routine frozen sections for parathyroid exploration in a resource poor setting
Removal of parathyroid is recommended for patients suffering from hypercalcemia due to excess parathyroid hormone levels. There are several causes for a hyperfunctioning parathyroid gland out of which parathyroid adenoma is the most common pathological entity. There is great variation in the number and location of parathyroid glands. Hence, intra operative confirmation of parathyroid tissue makes it easier for the surgeon to be confident of the outcome of the procedure and assure the patient of a permanent cure. A descriptive cross sectional study was done in a cohort of 26 patients who presented with elevated total serum calcium and parathyroid hormone concentrations. Intra operative frozen section diagnoses were correlated with routine histological studies and post operative parathyroid hormone concentration. The majority of patients were diagnosed as having parathyroid adenoma (88.46% Three out of 26 patients (11.53% had parathyroid hyperplasia involving more than one gland. Sensitivity and specificity of intraoperative frozen section diagnosis was 100% There was a statistically significant association (p In the light of the discussion on parathyroid surgery it is apparent that frozen sections play a pivotal role in resource poor settings, when facilities for novel intra operative imaging studies such as sestamibi scan and single photon emission computed tomography are limited. The participants of the study have been followed up during last 5 years with no evidence of residual disease or recurrence up to date.
Sri Lanka Journal of Surgery