Conventional bilateral cervical exploration versus open minimally invasive parathyroidectomy under local anaesthesia for primary hyperparathyroidism
(2005) In British Journal of Surgery 92(2). p.7-190- Abstract
BACKGROUND: Minimally invasive parathyroidectomy (MIP) has been introduced for the treatment of patients with primary hyperparathyroidism (pHPT). Thus far, only one randomized trial has compared video-assisted MIP with conventional bilateral cervical exploration (BCE). The value of open MIP is therefore not known.
METHODS: Fifty patients with a solitary parathyroid adenoma localized before surgery by sestamibi scintigraphy were randomized to undergo BCE under general anaesthesia (n = 25) or targeted MIP via a 2-cm incision using local anaesthesia (n = 25). Postoperative hypocalcaemia was the primary endpoint. Secondary outcome measures were operating time, complications, postoperative analgesia and recurrent disease. Follow-up was... (More)
BACKGROUND: Minimally invasive parathyroidectomy (MIP) has been introduced for the treatment of patients with primary hyperparathyroidism (pHPT). Thus far, only one randomized trial has compared video-assisted MIP with conventional bilateral cervical exploration (BCE). The value of open MIP is therefore not known.
METHODS: Fifty patients with a solitary parathyroid adenoma localized before surgery by sestamibi scintigraphy were randomized to undergo BCE under general anaesthesia (n = 25) or targeted MIP via a 2-cm incision using local anaesthesia (n = 25). Postoperative hypocalcaemia was the primary endpoint. Secondary outcome measures were operating time, complications, postoperative analgesia and recurrent disease. Follow-up was carried out at 1 and 6 months.
RESULTS: All patients who underwent BCE and 24 of those who had MIP were cured by the primary operation. Operating time was 22 min shorter in the MIP group (P = 0.024). Serum levels of calcium were slightly lower during the first 4 days after surgery in the BCE group (P = 0.022). No other no significant differences were found.
CONCLUSION: Targeted MIP using local anaesthesia reduces operating time and causes less postoperative biochemical hypocalcaemia compared with bilateral neck exploration.
(Less)
- author
- Bergenfelz, A LU ; Kanngiesser, V ; Zielke, A ; Nies, C and Rothmund, M
- publishing date
- 2005-02
- type
- Contribution to journal
- publication status
- published
- keywords
- Adenoma, Adolescent, Adult, Aged, Aged, 80 and over, Anesthesia, Local, Female, Humans, Hyperparathyroidism, Hypocalcemia, Male, Middle Aged, Minimally Invasive Surgical Procedures, Parathyroid Neoplasms, Parathyroidectomy, Postoperative Complications, Prospective Studies, Treatment Outcome, Video-Assisted Surgery, Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial
- in
- British Journal of Surgery
- volume
- 92
- issue
- 2
- pages
- 8 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:15573366
- scopus:13944260120
- ISSN
- 0007-1323
- DOI
- 10.1002/bjs.4814
- language
- English
- LU publication?
- no
- id
- 53304551-d58b-409f-9a0c-d60fec52af07
- date added to LUP
- 2017-05-10 17:30:46
- date last changed
- 2024-02-29 14:38:16
@article{53304551-d58b-409f-9a0c-d60fec52af07,
abstract = {{<p>BACKGROUND: Minimally invasive parathyroidectomy (MIP) has been introduced for the treatment of patients with primary hyperparathyroidism (pHPT). Thus far, only one randomized trial has compared video-assisted MIP with conventional bilateral cervical exploration (BCE). The value of open MIP is therefore not known.</p><p>METHODS: Fifty patients with a solitary parathyroid adenoma localized before surgery by sestamibi scintigraphy were randomized to undergo BCE under general anaesthesia (n = 25) or targeted MIP via a 2-cm incision using local anaesthesia (n = 25). Postoperative hypocalcaemia was the primary endpoint. Secondary outcome measures were operating time, complications, postoperative analgesia and recurrent disease. Follow-up was carried out at 1 and 6 months.</p><p>RESULTS: All patients who underwent BCE and 24 of those who had MIP were cured by the primary operation. Operating time was 22 min shorter in the MIP group (P = 0.024). Serum levels of calcium were slightly lower during the first 4 days after surgery in the BCE group (P = 0.022). No other no significant differences were found.</p><p>CONCLUSION: Targeted MIP using local anaesthesia reduces operating time and causes less postoperative biochemical hypocalcaemia compared with bilateral neck exploration.</p>}},
author = {{Bergenfelz, A and Kanngiesser, V and Zielke, A and Nies, C and Rothmund, M}},
issn = {{0007-1323}},
keywords = {{Adenoma; Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, Local; Female; Humans; Hyperparathyroidism; Hypocalcemia; Male; Middle Aged; Minimally Invasive Surgical Procedures; Parathyroid Neoplasms; Parathyroidectomy; Postoperative Complications; Prospective Studies; Treatment Outcome; Video-Assisted Surgery; Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial}},
language = {{eng}},
number = {{2}},
pages = {{7--190}},
publisher = {{Oxford University Press}},
series = {{British Journal of Surgery}},
title = {{Conventional bilateral cervical exploration versus open minimally invasive parathyroidectomy under local anaesthesia for primary hyperparathyroidism}},
url = {{http://dx.doi.org/10.1002/bjs.4814}},
doi = {{10.1002/bjs.4814}},
volume = {{92}},
year = {{2005}},
}