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Conventional bilateral cervical exploration versus open minimally invasive parathyroidectomy under local anaesthesia for primary hyperparathyroidism

Bergenfelz, A LU ; Kanngiesser, V; Zielke, A; Nies, C and Rothmund, M (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.

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author
publishing date
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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
John Wiley & Sons
external identifiers
  • 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
2017-08-27 06:40:42
@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},
  keyword      = {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    = {John Wiley & Sons},
  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},
  volume       = {92},
  year         = {2005},
}