{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:41:45Z","timestamp":1785840105339,"version":"3.56.0"},"reference-count":28,"publisher":"Royal College of Surgeons of England","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p> Mini-incision focused parathyroidectomy (MI-FP) is advocated as an alternative to bilateral neck exploration (BNE), owing to its reduced morbidity. The site and side of the affected gland is identified preoperatively using a combination of ultrasound and sestamibi scans. However, the acceptable degree of inter-scan concordance required to prompt MI-FP without compromising accuracy is undetermined. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> Accuracy of preoperative imaging was determined both individually and in combination for all parathyroidectomies (2007\u20132014). A grading system (excellent, good, poor) was devised to describe the interscan concordance, which was validated by the operative and histological findings. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Eighty-nine patients (17 male, 68 female) underwent parathyroidectomy (MI-FP 44, BNE 45). The accuracy of scans interpreted individually was 53% for ultrasound and 60% for sestamibi, with no difference according to surgical technique (P\u00a0=\u00a00.43, P =\u00a01, respectively). The proportion of interscan concordance was: excellent \u2013 35%, good \u2013 40%, poor 25%. Combined accuracy was 100% for both excellent and good grades but only 13% for those graded poor. Similar rates of normocalcaemia were observed for MI-FP and BNE, while postoperative hypocalcaemia was five times higher in those undergoing BNE. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p> Reduction in the inter-scan concordance from excellent to good does not compromise accuracy. MI-FP could be successfully performed in up to 75% of patients \u2013 25% higher than recommended in national guidelines. Focused parathyroidectomy does not compromise surgical and endocrinological outcomes but boasts a far superior complication rate. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2016.0271","type":"journal-article","created":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T14:58:48Z","timestamp":1485961128000},"page":"123-128","source":"Crossref","is-referenced-by-count":2,"title":["Scan-directed mini-incision focused parathyroidectomy: how accurate is accurate enough?"],"prefix":"10.1308","volume":"99","author":[{"given":"IM","family":"Shapey","sequence":"first","affiliation":[{"name":"Department of General Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Jabbar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, 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