%0 Journal Article
%T Feasibility of focused parathyroidectomy in developing countries-a scoping review.
%A Rugnath K
%A Kinoo SM
%J Gland Surg
%V 13
%N 6
%D 2024 Jun 30
%M 39015710
%F 2.16
%R 10.21037/gs-24-57
%X <B>UNASSIGNED: </B>The mainstay of treatment of primary hyperparathyroidism involves a parathyroidectomy, which depending on the number of affected parathyroid glands and the availability of resources, may involve a bilateral neck exploration with four gland assessment or a minimally invasive, focused parathyroidectomy (FP) necessitating pre-operative localisation. The feasibility of the latter is yet to be demonstrated in developing countries.<BR><B>UNASSIGNED: </B>A scoping review was performed with published literature evaluated from the past 15 years (2007 & onwards). Articles were screened and only included if they discussed FP, preoperative localisation, economic impact and they originated from a developing country (upper middle or lower middle-income).<BR><B>UNASSIGNED: </B>A total of 18 articles met the inclusion criteria, comprising seven developing countries (two upper middle-income and five lower middle-income countries). Preoperative localisation was performed in all studies, with overall accuracy rates of 75.5% for ultrasound and 85.7% for 99mTc sestamibi. A total 1,202 patients (70%) had FP. Five hundred and fifty-five patients underwent FP without intraoperative adjuncts and 647 underwent FP with intraoperative adjuncts, with adjusted cure rates of 95.3% and 99.2% respectively. Overall cure rate for FP was 96.4%.<BR><B>UNASSIGNED: </B>With access to accurate preoperative localisation and excellent cure rates with and without intraoperative adjuncts, we conclude that FP is feasible in developing countries.