title: Interest of video-assisted minimally invasive surgery in primary hyperparathyroidism.
abstract: BACKGROUND
  Surgery is the only radical and definitive treatment for primary hyperparathyroidism. Exploration of the four parathyroid sites is giving way to minimally invasive techniques. The present study sought to compare two minimally invasive parathyroidectomy techniques, by classical cervicotomy (MIP-C) and by video-assistance (MIP-VA), in terms of success rate, complications rate, operating time, and patient and community physician satisfaction.
  
  
  METHODS
  A non-randomized retrospective comparative study included 112 patients presenting with primary hyperparathyroidism with identified parathyroid adenoma, operated on between January 2005 and October 2010. The two groups were constituted according to the surgeons' habitual practice: 54 cases of MIP-VA and 58 of MIP-C.
  
  
  RESULTS
  Results for MIP-VA and MIP-C were respectively: success, 96.3% vs. 100% (P=0.09); mean scar size, 1.47 vs. 3.43cm (P<0.01); hypocalcemia, 2 vs. 3 cases (P=0.1); theater time, 94.25 vs. 76min (P=0.02); and postoperative stay, 1.08 vs. 1.37 days (P=0.07). Patient satisfaction was comparable between groups, while 93.3% of community physicians found MIP-VA preferable to MIP-C, although only 39.3% had known the MIP-VA technique.
  
  
  CONCLUSIONS
  With efficacy, morbidity and patient satisfaction comparable to classical surgery, MIP-VA significantly reduced cervicotomy size and hospital stay. Community physicians considered it to be preferable to MIP-C.
authors.affiliation: Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France. Electronic address: r-garrel@chu-montpellier.fr.
authors.forename: R
authors.initials: R
authors.lastname: Garrel
authors.affiliation: Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
authors.forename: M
authors.initials: M
authors.lastname: Bartolomeo
authors.affiliation: Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
authors.forename: M
authors.initials: M
authors.lastname: Makeieff
authors.affiliation: Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
authors.forename: L
authors.initials: L
authors.lastname: Crampette
authors.affiliation: Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
authors.forename: B
authors.initials: B
authors.lastname: Guerrier
authors.affiliation: Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
authors.forename: C
authors.initials: C
authors.lastname: Cartier
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D061646:Operative Time; D010282:Parathyroid Neoplasms / Q000150:complications / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D020535:Video-Assisted Surgery
keywords: Cervicotomy; Minimally invasive surgery; Parathyroid adenoma; Parathyroidectomy; Primary hyperparathyroidism; Video-assistance