title: [Minimally invasive parathyroidectomy with local anesthesia in conjunction with ultrasonography, sestamibi scintigraphy and intraoperative parathyroid hormone measurement].
abstract: BACKGROUND
  The standard procedure in patients with primary hyperparathyroidism (pHPT) includes cervical exploration and identification of all four enlarged parathyroid glands. New localization techniques, i.e., ultrasonography associated with color duplex sonography, 99mTc-sestamibi scintigraphy and the possibility of intraoperative parathormone (iPTH) measurement permit minimally invasive parathyroidectomy (MIP). Three different methods have been established: minimally invasive open parathyroidectomy, endoscopic parathyroidectomy and video-assisted parathyroidectomy. We present our experience with open MIP with the patient under local anesthesia (LA).
  
  
  METHODS
  In 25 patients with pHPT the operation was started under local anesthesia. Preoperatively, ultrasonography and sestamibi scintigraphy were performed in each patient. iPTH measurement was carried out intraoperatively.
  
  
  RESULTS
  In 23 patients (92%) the operation was done successfully in LA. There were no postoperative complications. During follow-up none of the patients developed hypercalcemia again.
  
  
  CONCLUSIONS
  MIP in connection with ultrasonography, sestamibi scintigraphy and intraoperative PTH measurement offers a promising treatment for patients with pHPT.
authors.affiliation: Klinik und Poliklinik für Allgemein- und Transplantationschirurgie, Universitätsklinikum Essen. frilling@uni-essen.de
authors.forename: A
authors.initials: A
authors.lastname: Frilling
authors.forename: R
authors.initials: R
authors.lastname: Görges
authors.forename: U
authors.initials: U
authors.lastname: Clauer
authors.forename: K
authors.initials: K
authors.lastname: Tecklenborg
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D004724:Endoscopy; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014463:Ultrasonography; D020535:Video-Assisted Surgery
chemical_list: D010281:Parathyroid Hormone; D017256:Technetium Tc 99m Sestamibi
vernacular_title: Minimal-invasive Parathyreoidektomie in Lokalanaesthesie in Verbindung mit Ultrasonographie, Sestamibi-Szintigraphie und intraoperativer Parathormonmessung.