Minimally invasive parathyroidectomy under local anesthesia: patient satisfaction and overall outcome.
OBJECTIVE
To compare minimally invasive parathyroidectomy (MIP) under local anesthesia (MIPULA) to minimally invasive parathyroidectomy performed under general anesthesia (MIPUGA) in terms of postoperative pain, postanesthetic side effects, patient satisfaction, and overall outcome.


METHODS
Prospective comparative cohort study.


METHODS
Consecutive consenting patients presenting to a single surgeon's practice were enrolled into MIPULA or MIPUGA groups if inclusion criteria were satisfied. A standard anesthesia and surgical protocol was followed for all included patients. Subjective outcome measurements (pain, overall satisfaction, and other variables) were achieved through questionnaires. Objective outcomes were also measured.


RESULTS
Seventy-four patients were enrolled: 58 in the MIPULA group and 16 in the MIPUGA group. Operative time and hospital stay were significantly shorter in the MIPULA group. Subjectively, the MIPULA group was significantly more ready for discharge versus the MIPUGA group. No significant difference in overall satisfaction between groups was noted. Biochemical cure and conversion (MIPULA to general anesthesia open exploration) rates for our cohort were 100% and 4%, respectively.


CONCLUSIONS
MIPULA confers significantly shorter operative time and hospital stay with no significant difference in subjective postoperative pain, patient satisfaction, overall outcome, or cure rate when compared to MIPUGA. Provided that appropriate preoperative localization and surgical experience are present, MIPULA can be offered to patients as a safe and reasonable alternative to MIPUGA.
Chau
Jason K M
JK
Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta.
Hoy
Monica
M
Tsui
Ban
B
Harris
Jeffrey R
JR
D000772:Anesthesia, Local / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D016105:Parathyroidectomy / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome