Video-assisted parathyroidectomy via the lateral approach vs conventional surgery in the treatment of sporadic primary hyperparathyroidism: results of a case-control study.
BACKGROUND
We previously demonstrated that minimally invasive video-assisted parathyroidectomy (VAP) can be performed via a lateral approach on the line of the sternocleidomastoid muscle. The aim of this study was to compare the results of this technique with those of conventional parathyroidectomy (CP) in a case-control study.


METHODS
Over a 2-year period, 80 VAP were attempted. The selection criteria were as follows: sporadic primary hyperparathyroidism, no history of previous neck surgery, no thyroid disease, suggestion of a single adenoma on preoperative imaging. A rapid intraoperative parathyroid hormone (PTH) assay was performed. The procedure was completed successfully in 68 patients. A case-control study of 68 patients who underwent CP for a single adenoma was performed. The controls were matched for age and sex.


RESULTS
All of the patients were normocalcemic at follow-up. No statistically significant differences between the VAP and the control groups were found for age, sex, pre- and postoperative calcemia and PTH, adenoma weight, operating time, complication rate, or postoperative stay. One VAP patient developed recurrent laryngeal nerve palsy. Patients who underwent VAP required less analgesics (p < 0.0001) and were more satisfied with the cosmetic results (p < 0.0001).


CONCLUSIONS
This study suggests that VAP by the lateral approach has some advantages over CP in terms of postoperative pain and cosmetic results.
Henry
J F
JF
Department of General and Endocrine Surgery, University Hospital La Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 5, France. jfhenry@ap-hm.fr
Raffaelli
M
M
Iacobone
M
M
Volot
F
F
D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016105:Parathyroidectomy / Q000379:methods*; D011183:Postoperative Complications; D020535:Video-Assisted Surgery