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Published on: September 15, 2023
Minimally invasive parathyroidectomy: 50 consecutive cases
L W Delbridge1, S J Dolan, T T Hop
1Department of Surgery, Royal North Shore Hospital, University of Sydney, NSW. leighd@med.usyd.edu.au
Objective:
To determine the effectiveness and outcomes of minimally invasive parathyroidectomy.
Design:
Prospective, non-randomised, non-blinded trial.
Setting:
Affiliated university teaching hospitals of the Northern Clinical School, University of Sydney, New South Wales, May 1998 to October 1999.
Patients:
50 consecutive patients who underwent minimally invasive parathyroidectomy for primary hyperparathyroidism, and 150 consecutive patients undergoing open parathyroidectomy over the same period.
Results:
Minimally invasive parathyroidectomy was successfully completed and resulted in cure (normocalcaemia) in 42 of 50 patients (84%). Seven patients (14%) required conversion to an open procedure, all of which also resulted in normocalcaemia, giving an overall cure rate of 98%. One patient had persistent hyperparathyroidism after minimally invasive parathyroidectomy which was cured at subsequent open reoperation. Three patients had a temporary recurrent laryngeal nerve palsy. Open parathyroidectomy was successful in 147 of 150 patients (98%) at initial operation; one patient had a temporary recurrent laryngeal nerve palsy. Intraoperative measurement of parathyroid hormone levels by a quick technique in 23 of the patients (13 having minimally invasive and 10 open procedures) correctly identified the presence of multiple-gland disease.
Conclusion:
Minimally invasive parathyroidectomy is a feasible procedure, although there are concerns about the complication rate.
