title: Long-term prospective evaluation comparing robotic parathyroidectomy with minimally invasive open parathyroidectomy for primary hyperparathyroidism.
abstract: Targeted parathyroidectomy is a popular technique for localized pathology. No single technique is established as superior. The purpose of this study was to compare robotic-assisted parathyroidectomy (RAP) with the most common approach.
  
  
  
  This was a prospective, nonrandomized study. Fifteen consecutive patients who underwent RAP were compared to 15 matched controls undergoing focused lateral parathyroidectomy (FLP).
  
  
  
  Biochemical cure occurred in 29 of 30 patients (97%). No major complications occurred, although there was 1 robotic conversion. RAP demonstrated a significant time reduction (R(2)  = 0.436; p = .01) but took much longer to perform than FLP (119 minutes vs 34 minutes; p = .001). RAP was associated with less initial postoperative pain (p = .036) and higher satisfaction with scar cosmesis (p = .002) until 6 months. Quality of life (QOL) improved in both groups (p = .007).
  
  
  
  RAP provides superior early cosmesis with equivalent global health improvement compared to FLP. The high cost and learning curve may preclude widespread adoption. Further evaluation is necessary to establish its clinical efficacy regarding scar cosmesis. © 2015 Wiley Periodicals, Inc. Head Neck 38: E300-E7, 2016.
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Tolley
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Garas
authors.affiliation: Department of Endocrine and Thyroid Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Fausto
authors.initials: F
authors.lastname: Palazzo
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Alexa
authors.initials: A
authors.lastname: Prichard
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Chaidas
authors.affiliation: Department of Endocrinology, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Cox
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Asit
authors.initials: A
authors.lastname: Arora
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016105:Parathyroidectomy / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D065287:Robotic Surgical Procedures
keywords: cosmesis; hyperparathyroidism; outcomes; robotic; surgery