Is minimally invasive parathyroidectomy reasonable in the nonuniversity setting?
BACKGROUND
Minimally invasive parathyroidectomy (MIPX) hinges on accurate preoperative localization and the intraoperative parathyroid hormone (IOPTH) assay to confirm adequate resection. Our goal was to evaluate the results of this technique when applied in a nonuniversity setting.


METHODS
All patients undergoing parathyroidectomy at our institution from August 2000 until June 2005 were retrospectively reviewed. Patients were divided into 2 groups: bilateral cervical exploration versus MIPX based on adequate preoperative localization.


RESULTS
There were 271 patients who underwent parathyroidectomy during the study period. Of these cases, 204 patients with primary hyperparathyroidism composed our study group. We observed that 136 patients (67%) had unilaterally positive localization studies (group 1), and MIPX was successfully completed in 52% of cases.


CONCLUSIONS
Although nearly all patients with single-gland disease should be candidates for MIPX, we found that adequate preoperative imaging and concurrent thyroid disease limited successful completion of the minimally invasive procedure.
Palmer
Robert M
RM
Greenville Memorial Hospital, Greenville Hospital System, 701 Grove Road, Greenville, SC 29605, USA. rpalmer07@yahoo.com <rpalmer07@yahoo.com>
Lokey
Jonathan S
JS
D000368:Aged; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods*; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography
D010281:Parathyroid Hormone; D017256:Technetium Tc 99m Sestamibi