title: Minimally invasive resection for mediastinal ectopic parathyroid glands.
abstract: BACKGROUND
  We reviewed our experience with ectopic mediastinal parathyroidectomy.
  
  
  METHODS
  Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism.
  
  
  RESULTS
  Primary hyperparathyroidism was the main diagnosis in 32 patients (97%). Technetium-sestamibi scan was used in 23 (70%) for preoperative localization. Minimally invasive resections were performed in 18 patients (55%), and 15 (45%) underwent open surgery. The most common minimally invasive surgery approach was video-assisted thoracoscopy in 9 patients (27%); the most common open approach was median sternotomy in 11 (33%). Intraoperative parathyroid hormone monitoring was used in 22 patients (67%). The ectopic glands were intrathymic in 15 patients (45%), in the aortopulmonary window in 7 (21%), and in other intrathoracic locations in the remaining 11 (33%). Parathyroid adenomas were identified in 21 patients (64%); parathyroid hyperplasia and carcinoma were identified in 9 (27%) and 3 (9%), respectively. No early mortality occurred in either group. Reoperation was required in 1 patient in the minimally invasive surgery group because of hemothorax. Morbidity occurred in 8 patients (24%), the most common of which was hypocalcemia in 4 (12%). The mean length of stay was significantly shorter in the minimally invasive surgery group (2 versus 6 days; p < 0.001) but mortality and morbidity were not statistically different between the two groups (p = 0.05). Mean follow-up was 3 ± 3.7 years.
  
  
  CONCLUSIONS
  Minimally invasive mediastinal parathyroidectomy has similar outcomes to open surgery, with significantly shorter length of hospital stay.
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Sameh M
authors: SM
authors: Said
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Stephen D
authors: SD
authors: Cassivi
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Mark S
authors: MS
authors: Allen
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Claude
authors: C
authors: Deschamps
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Francis C
authors: FC
authors: Nichols
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
authors: K Robert
authors: KR
authors: Shen
authors: Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: wigle.dennis@mayo.edu.
authors: Dennis A
authors: DA
authors: Wigle
mesh_terms: D002828:Choristoma / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010280:Parathyroid Glands; D016105:Parathyroidectomy / Q000379:methods*; D012189:Retrospective Studies
keywords: 13