Introduction:

The purpose of this study is to analyze the usefulness of methylene blue staining for intraoperative identification of parathyroid adenomas.

Material and methods:

A prospective longitudinal cohort study was performed. Operated patients with primary hyperparathyroidism were included. Methylene blue was used to dye and facilitate the identification of the pathological glands when there was discordance between preoperative information provided by the ultrasound and technetium (99)mTc-MIBI.

Results:

Intraoperative infusion of blue methylene was used in 43 patients. In 37 cases adenoma was visualized in dark blue, clearly evident from surrounding tissues. In six patients (14%) adenoma was not detected due to mediastinal, paraesophageal or intrathyroidal location, they were found in the same operation but not stained due to the increase in surgical time. No false positive case was found. No neurotoxic side effects were recorded. All patients returned to normocalcemia.

Conclusions:

Blue methylene infusion is a helpful intraoperative adjunct for identifying parathyroid adenomas, it also provides additional information to the usual exploratory procedures, it is safe and easy to use.

        · resumen en Español     · texto en Español     · Español ( pdf )