title: A comparison of minimally invasive video-assisted parathyroidectomy and traditional parathyroidectomy for parathyroid adenoma.
abstract: BACKGROUND
  Pre-operative imaging techniques for sporadic primary hyperparathyroidism (SPHPT) and intraoperative parathyroid hormone (ioPTH) have led to the wide spread use of minimally invasive surgical approaches.
  
  
  METHODS
  In our prospectively collected database, 157 subjects with SPHPT and a preoperative diagnosis of parathyroid adenoma were treated with parathyroidectomy between January 2003 and November 2011. Subjects in group A were enrolled between January 2003 to September 2006, and underwent traditional parathyroidectomy with intraoperative frozen section and bilateral neck exploration. Subjects in group B were enrolled between September 2006 to November 2011, and underwent minimally invasive video-assisted parathyroidectomy (MIVAP) with ioPTH. Operative times and post-operative pain levels were compared between groups. Subjects were followed for a minimum of 6 months post-operatively and recurrence rates and complication rates were measured between groups.
  
  
  RESULTS
  81 subjects were enrolled in group A, and 76 subjects were enrolled in group B. Pre-operative evaluation demonstrated that the groups were statistically similar. Significantly decreased operative times (28min vs. 62min) and post-operative pain levels were noted in group B. Recurrence rates were similar between group A (3.7%) and group B (2.6%).
  
  
  CONCLUSIONS
  MIVAP with ioPTH demonstrated significantly improved operative times and post-operative pain levels, while maintaining equivalent recurrence rates.
authors.affiliation: 1. Department of Surgery -University Hospital of Parma;
authors.forename: Paolo Del
authors.initials: PD
authors.lastname: Rio
authors.forename: Diego
authors.initials: D
authors.lastname: Vicente
authors.forename: Umberto
authors.initials: U
authors.lastname: Maestroni
authors.forename: Anna
authors.initials: A
authors.lastname: Totaro
authors.forename: Gian Maria Casoni
authors.initials: GM
authors.lastname: Pattacini
authors.forename: Itzhak
authors.initials: I
authors.lastname: Avital
authors.forename: Alexander
authors.initials: A
authors.lastname: Stojadinovic
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
keywords: Parathyroidectomy; minimally invasive surgical approach
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