Abstract

Research Article

Results of a prospective strategy for focused Minimally Invasive Parathyroidectomy (MIP)

Rosyli Reveron-Thornton and Jeffrey Norton*

Published: 03 May, 2023 | Volume 7 - Issue 1 | Pages: 016-018

Neck exploration for primary HPT is the standard operation in which 4 parathyroid glands are identified and one abnormal parathyroid gland is removed. This is recommended for all patients with primary HPT. We hypothesized that most patients with primary HPT have a single abnormal parathyroid gland (adenoma) and parathyroid imaging studies will identify it and support a focused minimally invasive parathyroidectomy (MIP). This can be combined with ioPTH monitoring making bilateral exploration unnecessary. This paper reports a 93.4% success rate in 249 consecutive prospective patients with primary HPT over a 15-year period with a short operating time and few complications. The findings suggest that this alternate surgical MIP approach should be the procedure of choice for HPT patients.

Read Full Article HTML DOI: 10.29328/journal.ascr.1001069 Cite this Article Read Full Article PDF

References

  1. Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, Potts JT Jr. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014 Oct;99(10):3561-9. doi: 10.1210/jc.2014-1413. Epub 2014 Aug 27. PMID: 25162665; PMCID: PMC5393490.
  2. Powell AC, Alexander HR, Chang R, Marx SJ, Skarulis M, Pingpank JF, Bartlett DL, Hughes M, Weinstein LS, Simonds WF, Collins MF, Shawker T, Chen CC, Reynolds J, Cochran C, Steinberg SM, Libutti SK. Reoperation for parathyroid adenoma: a contemporary experience. Surgery. 2009 Dec;146(6):1144-55. doi: 10.1016/j.surg.2009.09.015. PMID: 19958942; PMCID: PMC3467310.
  3. Fahy BN, Bold RJ, Beckett L, Schneider PD. Modern parathyroid surgery: a cost-benefit analysis of localizing strategies. Arch Surg. 2002 Aug;137(8):917-22; discussion 922-3. doi: 10.1001/archsurg.137.8.917. PMID: 12146990.
  4. Doherty GM, Weber B, Norton JA. Cost of unsuccessful surgery for primary hyperparathyroidism. Surgery. 1994 Dec;116(6):954-7; discussion 957-8. PMID: 7985102.
  5. Quinn AJ, Ryan ÉJ, Garry S, James DL, Boland MR, Young O, Kerin MJ, Lowery AJ. Use of Intraoperative Parathyroid Hormone in Minimally Invasive Parathyroidectomy for Primary Hyperparathyroidism: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2021 Feb 1;147(2):135-143. doi: 10.1001/jamaoto.2020.4021. PMID: 33211086; PMCID: PMC7677873.
  6. Ishii H, Mihai R, Watkinson JC, Kim DS. Systematic review of cure and recurrence rates following minimally invasive parathyroidectomy. BJS Open. 2018 May 28;2(6):364-370. doi: 10.1002/bjs5.77. PMID: 30511037; PMCID: PMC6254009.

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