Video-assisted parathyroidectomy via the lateral approach vs conventional surgery in the treatment of sporadic primary hyperparathyroidism

• Published in: Surgical endoscopy Vol. 15; no. 10; pp. 1116 - 1119
• Main Authors: Henry, J.F., Raffaelli, M., Iacobone, M., Volot, F.
• Format: Journal Article
• Language: English
• Published: New York Springer Nature B.V 01-10-2001
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-001-9013-x

Background: We previously demonstrated that minimally invasive video-assisted parathyroidectomy (VAP) can be performed via a lateral approach on the line of the sternocleidomastoid muscle. The aim of this study was to compare the results of this technique with those of conventional parathyroidectomy (CP) in a case-control study. Methods: Over a 2-year period, 80 VAP were attempted. The selection criteria were as follows: sporadic primary hyperparathyroidism, no history of previous neck surgery, no thyroid disease, suggestion of a single adenoma on preoperative imaging. A rapid intraoperative parathyroid hormone (PTH) assay was performed. The procedure was completed successfully in 68 patients. A case-control study of 68 patients who underwent CP for a single adenoma was performed. The controls were matched for age and sex. Results: All of the patients were normocalcemic at follow-up. No statistically significant differences between the VAP and the control groups were found for age, sex, pre- and postoperative calcemia and PTH, adenoma weight, operating time, complication rate, or postoperative stay. One VAP patient developed recurrent laryngeal nerve palsy. Patients who underwent VAP required less analgesics (p <0.0001) and were more satisfied with the cosmetic results (p <0.0001). Conclusions: This study suggests that VAP by the lateral approach has some advantages over CP in terms of postoperative pain and cosmetic results.