Radio-guided video-assisted parathyroidectomy: a preliminary report.
BACKGROUND
The surgical management of primary hyperparathyroidism is changing both in terms of the extent of cervical exploration and in technique. There are many new mini-invasive procedures for neck surgery. We describe our preliminary experience with a technique that combines two mini-invasive procedures--radio-guided and video-assisted parathyroidectomy.


METHODS
Six consecutive patients with no recurrent or persistent primary hyperparathyroidism, no previous cervical operations, and no thyroid pathologies were selected to undergo radio-guided video-assisted parathyroidectomy.


RESULTS
One case was converted. There was no morbidity or mortality in the postoperative period. Six parathyroids were removed; the histological diagnosis was adenoma in all cases. All patients were discharged on the 1st postoperative day. Calcium serum levels normalized in all cases, with only one case of transient postoperative hypocalcemia. All patients were normocalcemic after 6 months.


CONCLUSIONS
Radio-guided video-assisted parathyroidectomy is feasible in selected patients. However, longer follow-up and more cases are necessary before this procedure can be applied routinely.
De Pasquale
L
L
Second Department of General Surgery, University of Milan, S. Paolo Hospital, v. A. di Rudini, 20142 Milan, Italy. Amelia.Bastagli@unimi.it
Bianchi
P
P
Barabino
M
M
Bestetti
A
A
Bastagli
A
A
D000236:Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery; D006962:Hyperparathyroidism, Secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000601:surgery; D016105:Parathyroidectomy / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D020535:Video-Assisted Surgery / Q000379:methods*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi