title: Totally endoscopic lateral parathyroidectomy: prospective evaluation of 200 patients. ESES 2010 Vienna presentation.
abstract: 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.
authors.affiliation: Department of Digestive, Hepatobiliary, and Endocrine Surgery, CHU Nancy-Brabois (Hopital Adultes), University of Nancy, 11 allée du morvan, 54511 Vandoeuvre-les-Nancy, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Fouquet
authors.forename: Adeline
authors.initials: A
authors.lastname: Germain
authors.forename: Rasa
authors.initials: R
authors.lastname: Zarnegar
authors.forename: Marc
authors.initials: M
authors.lastname: Klein
authors.forename: Nicole
authors.initials: N
authors.lastname: De Talance
authors.forename: Jean
authors.initials: J
authors.lastname: Claude Mayer
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
mesh_terms: 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