[Minimally invasive treatment of primary hyperparathyroidism].
BACKGROUND
Parathyroid glands have traditionally been identified by bilateral neck exploration under general anaesthesia in connection with surgical removal of enlarged glands in primary hyperparathyroidism. Unilateral neck exploration can now be done under local anaesthesia without dissecting all glands, due to improved preoperative scintigraphy and measurement of parathyroid hormone (PTH) intra-operatively. This minimally invasive technique was introduced at the University Hospital of Northern Norway in 2004.


METHODS
Data on patients who had undergone minimally invasive surgery were collected from patient files from 1 January 2004 to 31 December 2006. 41 patients were included in the study.


RESULTS
PTH had normalized for 97% of the patients post-operatively. 7% of the patients had transient hypocalcaemia at discharge. One patient suffered from paralysis of the recurrent laryngeal nerve after surgery. Local anaesthesia had to be converted to general anaesthesia for seven operations (17%).


CONCLUSIONS
Preoperative scintigraphy and intra-operative measurements of PTH have made minimally invasive surgery possible. It is currently our preferred treatment in case of unilateral pathology in the parathyroid glands.
Lindekleiv
Haakon
H
Avdeling for urologi og endokrin kirurgi, Nukleaermedisinsk seksjon, Universitetssykehuset Nord-Norge, Postboks 100, 9038 Tromsø.
Due
Jan
J
Thuy
Lu
L
Hansen
Tor Arne
TA
Nilsen
Paul Age
PA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D016105:Parathyroidectomy / Q000379:methods*; D011300:Preoperative Care; D011877:Radionuclide Imaging