Ontology type: schema:ScholarlyArticle
1999-07
AUTHORSG. Prager, Ch. Passler, Ch. Scheuba, R. Udelsman, G. Gasparri, Bruno Niederle
ABSTRACTBackground: Although bilateral neck exporation is the standard procedure in biochemically proven primary hyperparathyroidism a unilateral approach was developed to reduce surgical trauma, morbidity and duration of operation. The improvement of preoperative localisation methods and the introduction of a quick parathyroid hormone (QPTH) assay have helped to establish minimally invasive techniques.Methods: Reviewing literature, the clinical value of minimally invasive open parathyroidectomy (MIP; localized single gland disease, lateral approach through a 15–20 mm incision, selected exstirpation of the parathyroid tumor, documentation of the surgical success using QPTH assay) was analyzed and compared with endoscopic procedures.Results: Reviewing literature, eight authors describe 436 patients witReviewing literature, eight authors describe 436 patients with MIP. MIP was successfully performed in 401 out of 436 patients (92 %). A conversion to standard bilateral exploration was performed in 29 patients. Causes for conversion were false positive localisation in 12 (41 %), multiple gland disease in seven (24 %), double adenoma in four (14 %), difficult dissection in four (14%), concomitant thyroid disease in one and scars during reoperation in another. Complications are documented in three patients (0.7 %; paralysis of recurrent laryngeal nerve: two; rupture of a cystic parathyroid adenoma: one).Conclusions: Because of good functioning and excellent cosmetic results MIP is a cost-effective alternative to endoscopic procedures in localised single gland disease. Using a paramedian miniincision, the recurrent laryngeal nerve can be visualized and concomitant ipsilateral thyroid pathology can be treated. MIP is also feasible in reoperations. Intraoperative QPTH assay is mandatory. More... »
PAGES221-226
http://scigraph.springernature.com/pub.10.1007/bf02620168
DOIhttp://dx.doi.org/10.1007/bf02620168
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