Parathyroidectomy outcomes according to operative approach.

Beyer TD, Solorzano CC, Starr F, Nilubol N, Prinz RA
Am J Surg. 2007 193 (3): 368-72; discussion 372-3

PMID: 17320537 · DOI:10.1016/j.amjsurg.2006.09.023

BACKGROUND - Parathyroidectomy for primary sporadic hyperparathyroidism (psHPT) has evolved with advances in preoperative gland localization and intraoperative parathyroid hormone (ioPTH) monitoring to minimally invasive approaches (MIPS).

METHODS - Two hundred twenty patients underwent parathyroidectomy for psHPT. Forty-nine patients underwent bilateral neck exploration (BNE) (group 1), 60 patients underwent BNE with ioPTH monitoring (group 2), and 111 patients underwent MIPS with ioPTH monitoring (group 3).

RESULTS - At 3 months postoperatively, mean serum calcium and intact parathyroid hormone (PTH) levels were similar between groups, and eucalcemia rates were 100%, 100%, and 99%. The ultimate rates of persistent disease and recurrence were also similar. Operative time was shorter in group 3 compared to group 2 (P < .001) but not group 1. Frozen sections and patient charges were significantly lower in group 3 compared to groups 1 and 2 (P < .005).

CONCLUSION - Parathyroidectomy for psHPT is highly successful with these techniques. When a MIPS approach can be done, it is potentially quicker and associated with lower patient charges.

MeSH Terms (15)

Calcium Female Follow-Up Studies Humans Hyperparathyroidism, Primary Length of Stay Male Middle Aged Monitoring, Intraoperative Parathyroidectomy Parathyroid Hormone Recurrence Recurrent Laryngeal Nerve Injuries Retrospective Studies Treatment Outcome

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