title: Minimally invasive parathyroidectomy under local anesthesia.
abstract: BACKGROUND
  More than 85% of primary hyperparathyroidism (PHPT) cases are due to solitary, benign parathyroid adenomas. Recently, the success rate of Tc99m sestamibi scintigraphy in localization has made minimally invasive parathyroidectomy (MIP) more prominent. MIP is as effective as conventional bilateral neck exploration. Moreover, it offers lower morbidity, cost effectiveness, and better cosmetics effects.
  
  
  OBJECTIVE
  We aimed to evaluate the success of MIP, which happens only under local anesthesia, in this study.
  
  
  METHODS
  Total of 63 patients were operated for PHPT, of which 54 had solitary adenoma. Five patients underwent bilateral neck exploration under general anesthesia for thyroid nodules or unlocalizated adenomas. A total of 49 patients underwent MIP under local anesthesia without any sedation. During MIP, gamma probe was used for all patients. The patients were followed for parathyroid functions.
  
  
  RESULTS
  The mean age of 49 patients with MIP (5 male, 44 female) was 59 years. The mean follow-up time was 16.4 (±10.1) months (range: 2-36 months). Of the 49 patients, 47 (96%) were totally cured. In 2 patients, the procedure was switched to conventional bilateral neck exploration. Temporary hypocalcaemia was noted in 4 patients.
  
  
  CONCLUSIONS
  If the adenoma is localizated, MIP under only local anesthesia can be performed with a high success rate. Gamma probe-guided MIP under local anesthesia is an effective and safe method. It has the advantage of being minimally invasive and, therefore, it should be preferred over the conventional method.
authors.affiliation: Department of General Surgery, Internal Medicine Clinic, Konya Training and Research Hospital, Konya, Turkey.
authors.forename: Ö
authors.initials: Ö
authors.lastname: Karahan
authors.forename: A
authors.initials: A
authors.lastname: Okus
authors.forename: B
authors.initials: B
authors.lastname: Sevinç
authors.forename: M A
authors.initials: MA
authors.lastname: Eryilmaz
authors.forename: S
authors.initials: S
authors.lastname: Ay
authors.forename: M
authors.initials: M
authors.lastname: Çayci
authors.forename: C
authors.initials: C
authors.lastname: Duran
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000601:surgery; D006996:Hypocalcemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000601:surgery*; D010281:Parathyroid Hormone / Q000032:analysis; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy; D011877:Radionuclide Imaging; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone