Totally endoscopic lateral parathyroidectomy: prospective evaluation of 200 patients. ESES 2010 Vienna presentation.
OBJECTIVE
Several new minimally invasive techniques (mini-open, video-assisted, and endoscopic procedures) for parathyroidectomy have been described. However, totally endoscopic lateral approach parathyroidectomy (Henry technique) is not routinely performed.


METHODS
This is a prospective study of 200 consecutive patients that underwent totally endoscopic lateral parathyroidectomy.


RESULTS
Two hundred of 387 patients (52%) with primary hyperparathyroidism were included. Fifty-six patients (28%) were converted to open parathyroidectomy. Causes for conversion were lack of intraoperative localization (11%), difficult dissection (10%), bleeding (4%), failure of normalization of IOPTH results (2%), and other causes (1%). Gland localization (areas 1 to 2 versus area 3) and CaPTHus score (<3 versus ≥3) were not associated with the risk of conversion. Mean postoperative follow-up was 13 months, and 196 patients (98%) were cured.


CONCLUSIONS
Totally endoscopic lateral approach can be proposed in more than half of the patients with good immediate results. Conversion rate remains important and may explain low acceptance rate of this technique.
Fouquet
Thibaut
T
Department of Digestive, Hepatobiliary, and Endocrine Surgery, CHU Nancy-Brabois (Hopital Adultes), University of Nancy, 11 allée du morvan, 54511 Vandoeuvre-les-Nancy, France.
Germain
Adeline
A
Zarnegar
Rasa
R
Klein
Marc
M
De Talance
Nicole
N
Claude Mayer
Jean
J
Ayav
Ahmet
A
Bresler
Laurent
L
Brunaud
Laurent
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult