Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study

Area of Science:

• Endocrine Surgery
• Minimally Invasive Surgical Techniques
• Parathyroid Gland Disorders

Background:

• Primary hyperparathyroidism is a condition often treated with parathyroidectomy.
• Minimally invasive parathyroidectomy has emerged as a feasible treatment option.
• This study prospectively compares minimally invasive video-assisted parathyroidectomy (VAP) with traditional open surgery.

Purpose of the Study:

• To compare the outcomes of video-assisted parathyroidectomy (VAP) with conventional open parathyroidectomy.
• To evaluate operative time, postoperative pain, cosmetic results, and complications.
• To assess the efficacy of VAP in treating primary hyperparathyroidism.

Main Methods:

• A prospective randomized study involving 38 patients eligible for VAP.
• Patients were divided into two groups: conventional cervicotomy (Group A) and VAP with intraoperative parathyroid hormone measurement (Group B).
• Key outcomes measured included operative time, postoperative pain, fever, hypocalcemia, cosmetic results, and costs.

Main Results:

• Both groups showed no persistent primary hyperparathyroidism.
• Video-assisted parathyroidectomy (VAP) group had significantly shorter operative times (57 vs. 70 minutes).
• The VAP group experienced significantly better cosmetic results and less postoperative pain, though one case of recurrent laryngeal nerve palsy occurred.

Conclusions:

• Video-assisted parathyroidectomy (VAP) is associated with reduced operative time compared to conventional surgery.
• VAP offers superior cosmetic outcomes and a less painful postoperative experience.
• VAP represents an effective minimally invasive alternative for treating primary hyperparathyroidism.