Management of primary hyperthyroidism: toward minimal access surgery.
Fifteen years ago, bilateral exploration of the neck was dogma in parathyroid surgery. Now, less invasive procedures can be used to target lesions identified by new tests such as dual-phase Sestamibi scanning or intraoperative documentation of parathyroid hormone (PTH) level changes after removal of a parathyroid gland. A hand-held gamma probe can be used for intraoperative detection of high-uptake lesions, and video-assisted endoscopic surgery has been used successfully. With these new techniques, surgical exploration can be confined to one side of the neck through smaller incisions associated with better cosmetic results. The operating time is reduced, and in some cases the procedure can be done under local anesthesia. The objective of this article is to describe recent changes in the management of parathyroid adenoma requiring surgery.
Malinvaud
David
D
ENT and Head and Neck Surgery Department, Service d'oto-rhino-laryngologie et de chirurgie de la face et du cou, Morvan Hospital, Brest Teaching Hospital, 5, avenue Foch, 29609 Brest cedex, France. malinvaudd@hotmail.com
Potard
Gaël
G
Fortun
Cyrille
C
Saraux
Alain
A
Jézéquel
Joseph André
JA
Marianowski
Rémi
R
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011877:Radionuclide Imaging; D018570:Risk Assessment; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods