Role of Preoperative Localization Before Focused Parathyroidectomy in Case of Parathyroid Adenoma

<i>Background: </i>Commonly, primary hyperparathyroidism is caused by a single parathyroid adenoma; a smaller fraction are hyperplasia, or multigland disease. Prelocalization of the diseased parathyroid gland is key to effective parathyroidectomy. Focused parathyroidectomy has become the standard treatment for selected patients with primary hyperparathyroidism. The aim is to assess the role of preoperative localization before doing focused parathyroidectomy. <i>Methods: </i>From July 2022 to June 2023, this cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University's general surgery department in Dhaka. 14 patients with primary hyperparathyroidism had focused parathyroidectomy. Statistical analysis of the results was obtained by using window-based computer software with IBM SPSS statistics (Version 22). <i>Results: </i>The male-to-female ratio was 2.5:1, and the mean age was 32.36 years (SD = 9.76). The sensitivity, specificity, and accuracy for the ultrasound’s validity test were 75.0%, 50.0%, and 71.4%, respectively. The validity test for the Sestamibi scan has an accuracy of 85.7%, a specificity of 0.0%, and a sensitivity of 100.0%. The biochemical frozen section validity test's sensitivity, specificity, accuracy, and positive and negative predictive values were all 100%. The majority of individuals (85.7%) in the histopathology study investigation had parathyroid adenoma. The range of the postoperative hospital stay was 2 to 19 days, with an average of 8.2±6.26 days. Not all patients who underwent surgery had ugly scars. <i>Conclusion: </i>Preoperative localization enables patients to have focused parathyroidectomy, which is potentially cost effective, reduce postoperative complication, hospital stay with good cosmesis and patient satisfaction; ultimately improve postoperative outcome.