Bilateral oblique approach to parathyroid glands.
OBJECTIVE
To propose a simple and minimally invasive approach for parathyroid surgery.


BACKGROUND
Minimally invasive approaches to the parathyroid glands may involve preoperative morphologic explorations, perioperative biologic controls, or videocervicoscopy, a new method.


METHODS
The authors describe 597 patients who underwent parathyroidectomy through an original bilateral oblique approach between 1976 and 1997. None underwent morphologic exploration or biologic perioperative monitoring. In primary hyperparathyroidism, the four glands are controlled and it is possible to check their abnormalities of location or number. In secondary hyperparathyroidism and multiple endocrine neoplasia (MEN), a total or subtotal parathyroidectomy is performed.


RESULTS
The results and vocal morbidity are the same as that from authors using transverse cervicotomy, but this approach is more comfortable for the patient and allows total exploration of the location through short incisions without bleeding, visceral contusions, or muscle lesion.


CONCLUSIONS
This cervicotomy is easy and secure even if the surgeon is not trained in this approach because it uses and respects the anatomy of the cervical fasciae. It can be used without preoperative localization, intraoperative monitoring, or specialized material. But this approach could be also proposed for unilateral exploration guided by these methods and for surgical treatment of recurrent hyperparathyroidism after a transverse cervicotomy.
Chaffanjon
P C
PC
Service de Chirurgie Générale et Thoracique, Centre Hospitalier et Universitaire de Grenoble, France.
Brichon
P Y
PY
Sarrazin
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000473:pathology / Q000601:surgery*; D006962:Hyperparathyroidism, Secondary / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000473:pathology / Q000601:surgery*; D010280:Parathyroid Glands / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D016896:Treatment Outcome