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Focused parathyroidectomy through an open‐lateral approach for treating solitary parathyroid adenoma
Author(s) -
Yang Zhili,
Guo Minggao,
Wu Bo,
Zheng Qi,
Fan Youben
Publication year - 2015
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12149
Subject(s) - medicine , parathyroidectomy , parathyroid adenoma , primary hyperparathyroidism , surgery , hypocalcaemia , parathyroid gland , adenoma , parathyroid hormone , calcium
Aim Most cases of primary hyperparathyroidism are caused by a solitary parathyroid adenoma. Many patients are now being treated with focused approaches in parathyroidectomy. The aim of the present study was to investigate the safety and efficacy of focused parathyroidectomy that is performed through an open‐lateral approach under the effect of regional anaesthesia. Patients and Methods We carried out a retrospective analysis of 210 patients with solitary parathyroid adenoma. Ninety‐five patients underwent conventional middle‐access exploration, while the remaining 115 patients underwent focused parathyroidectomy through an open‐lateral approach. We recorded biochemical parameters of these patients at the preoperative and postoperative stages and during the follow‐up period. We compared the operative times, hospital stays and morbidity rates of these patients. Results There was one case of relapse in each group during the follow‐up period. These two cases were treated with focused parathyroidectomy through an open‐lateral approach under the effect of cervical plexus block anaesthesia. All the other patients were cured by the primary operation. Regional anaesthesia was administered to all patients who were treated with focused parathyroidectomy. However, owing to an ectopical parathyroid gland, one patient required general anaesthesia. There was no significant difference in temporary hypocalcaemia of these patients postoperatively ( P > 0.05). Compared to conventional parathyroidectomy, the focused approach was more advantageous, with shorter operative times, smaller scar lengths and shorter hospital stays ( P < 0.05). Conclusions When focused parathyroidectomy is performed through an open‐lateral approach, it is safe and effective, even under the effect of regional anaesthesia, provided an accurate localization is conducted.