Minimal-access/minimally invasive parathyroidectomy for primary hyperparathyroidism.
Minimal-access or minimally invasive parathyroidectomy is replacing a bilateral neck exploration as the surgical approach of choice in primary hyperparathyroidism (pHPT). When a parathyroid adenoma is localized preoperatively, ideally with sestamibi combined with ultrasonography, results equivalent to a bilateral neck exploration can be achieved through an incision less than 2.5 cm. Minimal-access techniques offer the advantage of cure under local anesthesia with a smaller incision and no overnight stay. Intraoperative measurement of parathyroid hormone (PTH) may be a valuable adjunct to confirmation of parathyroid adenoma removal, but currently appears to add little when preoperative localization is optimized. Controlled studies and long-term follow-up will be required to establish the true value of parathyroid minimal-access surgery.
Palazzo
F Fausto
FF
Department of Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia.
Delbridge
Leigh W
LW
D003949:Diagnostic Techniques, Surgical; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods*
D010281:Parathyroid Hormone