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Use of minimally invasive parathyroidectomy techniques in sporadic primary hyperparathyroidism: systematic review

  • D Gracie (a1) and S S M Hussain (a1) (a2)
Abstract

The past two decades have seen rapidly changing attitudes towards the surgical management of primary hyperparathyroidism. Advances in localisation techniques and confidence with endoscopy have led to the development of numerous minimally invasive parathyroidectomy approaches, including open minimal incision and endoscopic and video-assisted parathyroidectomy.

This paper systematically reviews the evidence for these methods to determine: (1) whether these new, minimally invasive techniques are comparable to conventional bilateral neck exploration methods in terms of success and complication rate; and (2) if they are comparable, which technique is likely to be best for cosmesis, patient safety and patient satisfaction.

A search of the Medline, Cochrane Reviews and Scopus databases was conducted, using a defined list of search parameters. Abstracts were compared against inclusion and exclusion criteria, before the full text was sought and analysed for data. The evidence from each study was then assessed, based on study quality, and a recommendation made based on the level of evidence available.

There is level 1b evidence that minimally invasive surgery is comparable to bilateral neck exploration in terms of efficacy and complication rates. This paper recommends that the treatment of choice for solitary adenoma (in most healthcare centres) should be open minimal incision parathyroidectomy, due to advantages in operative duration, learning curve and cost-effectiveness.

Copyright
Corresponding author
Address for correspondence: Mr S S Musheer Hussain, Consultant Otolaryngologist, Honorary Reader, Ward 26, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK Fax: +44 (0)1382 632 816 E-mail: musheer.hussain@nhs.net
References
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1Fraser, WD. Hyperparathyroidism. Lancet 2009;11:374:145–58
2Yu, N, Donnan, PT, Murphy, MJ, Leese, GP. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol 2009;71:485–93
3Bilezikian, JP, Potts, JT. Asymptomatic primary hyperparathyroidism: new issues and new questions – bridging the past with the future. J Bone Miner Res 2002;17(suppl 2):N5767
4Mazzaglia, PJ, Berber, E, Kovach, A, Milas, M, Esselstyn, C, Siperstein, AE. The changing presentation of hyperparathyroidism over 3 decades. Arch Surg 2008;143:260–6
5Udelsman, R, Pasieka, JL, Sturgeon, C, Young, JEM, Clark, OH. Surgery for asymptomatic primary hyperparathyroidism: proceedings of the Third International Workshop. J Clin Endocrinol Metab 2009;94:366–72
6Thomas, SK, Wishart, GC. Trends in surgical techniques. Nucl Med Commun 2003;24:115–19
7Marazuela, M, Domínguez-Gadea, L, Manuel Bravo-Linfante, J, Larrañaga, E. Surgical treatment and localization techniques in primary hyperparathyroidism. Endocrinol Nutr 2009;56:20–8
8Lowney, JK, Weber, B, Johnson, S, Doherty, GM. Minimal incision parathyroidectomy: cure, cosmesis, and cost. World J Surg 2000;24:1442–5
9Naitoh, T, Gagner, M, Garcia-Ruiz, A, Heniford, BT. Endoscopic endocrine surgery in the neck. An initial report of endoscopic subtotal parathyroidectomy. Surg Endosc 1998;12:202–5
10Henry, JF, Raffaelli, M, Iacobone, M, Volot, F. Video-assisted parathyroidectomy via the lateral approach vs conventional surgery in the treatment of sporadic primary hyperparathyroidism: results of a case-control study. Surg Endosc 2001;15:1116–19
11Miccoli, P, Bendinelli, C, Berti, P, Vignali, E, Pinchera, A, Marcocci, C. Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study. Surgery 1999;126:1117–21
12Prager, G, Czerny, C, Kurtaran, A, Passler, C, Scheuba, C, Bieglmayer, C et al. Minimally invasive open parathyroidectomy in an endemic goiter area: a prospective study. Arch Surg 2001;136:810–16
13Pitale, A, Andrabi, SIH, Dolan, SJ, Russell, CFJ. Minimally invasive parathyroid exploration for solitary adenoma. Initial experience with an open, ‘short incision’ approach. Ulster Med J 2008;77:115–18
14Miccoli, P, Berti, P, Puccini, M, Bendinelli, C, Conte, M, Picone, A et al. Video-assisted parathyroidectomy: a series of 85 cases [in French]. Chirurgie 1999;124:511–15
15Delbridge, LW, Dolan, SJ, Hop, TT, Robinson, BG, Wilkinson, MR, Reeve, TS. Minimally invasive parathyroidectomy: 50 consecutive cases. Med J Aust 2000;172:418–22
16Miccoli, P, Berti, P, Conte, M, Raffaelli, M, Materazzi, G. Minimally invasive video-assisted parathyroidectomy: lesson learned from 137 cases. J Am Coll Surg 2000;191:613–18
17Berti, P, Raffaelli, M, Materazzi, G, Galleri, D, Miccoli, P. Video-assisted parathyroidectomy: learning curve. Ann Chir 2001;126:772–6
18Cougard, P, Goudet, P, Bilosi, M, Peschaud, F. Video-endoscopic approach for parathyroidectomy: results of a prospective study including 100 patients. Ann Chir 2001;126:314–19
19Lorenz, K, Miccoli, P, Monchik, JM, Duren, M, Dralle, H. Minimally invasive video-assisted parathyroidectomy: multiinstitutional study. World J Surg 2001;25:704–7
20Mourad, M, Ngongang, C, Saab, N, Coche, E, Jamar, F, Michel, J-M et al. Video-assisted neck exploration for primary and secondary hyperparathyroidism: initial experience. Surg Endosc 2001;15:1112–15
21Hallfeldt, KK, Trupka, A, Gallwas, J, Schmidbauer, S. Minimally invasive video-assisted parathyroidectomy and intraoperative parathyroid hormone monitoring. The first 36 cases and some pitfalls. Surg Endosc 2002;16:1759–63
22Monchik, JM, Barellini, L, Langer, P, Kahya, A. Minimally invasive parathyroid surgery in 103 patients with local/regional anesthesia, without exclusion criteria. Surgery 2002;131:502–8
23Shimizu, K, Kitagawa, W, Akasu, H, Hatori, N, Hirai, K, Tanaka, S. Video-assisted endoscopic thyroid and parathyroid surgery using a gasless method of anterior neck skin lifting: a review of 130 cases. Surgery Today 2002;32:862–8
24Lo, CY, Chan, WF, Luk, JM. Minimally invasive endoscopic-assisted parathyroidectomy for primary hyperparathyroidism. Surg Endosc 2003;17:1932–6
25Miccoli, P, Berti, P, Materazzi, G, Massi, M, Picone, A, Minuto, MN. Results of video-assisted parathyroidectomy: single institution's six-year experience. World J Surg 2004;28:1216–18
26Rubello, D, Mariani, G, Pelizzo, MR. Minimally invasive radio-guided parathyroidectomy on a group of 452 primary hyperparathyroid patients: refinement of preoperative imaging and intraoperative procedure [in italian]. Nuklear Medizin 2007;46:8592
27Miccoli, P, Materazzi, G, Bonari, G, Donatini, G, Berti, P. Minimally invasive video-assisted parathyroidectomy. Operative Techniques in Otolaryngology – Head and Neck 2008;19:22–5
28Dobrinja, C, Trevisan, G, Liguori, G. Minimally invasive video-assisted parathyroidectomy. Initial experience in a general surgery department. J Endocrinol Invest 2009;32:130–3
29Kessler, PA, Bumiller, L, Kroczek, A, Kessler, HP, Birkholz, T. Minimally invasive neck surgery. Surgical feasibility and physiological effects of carbon dioxide insufflation in a unilateral subplatysmal approach. Int J Oral Maxillofac Surg 2009;38:766–72
30Lombardi, CP, Raffaelli, M, Traini, E, De Crea, C, Corsello, SM, Bellantone, R. Video-assisted minimally invasive parathyroidectomy: benefits and long-term results. World J Surg 2009;33:2266–81
31Henry, JF, Defechereux, T, Gramatica, L, De Boissezon, C. Endoscopic parathyroidectomy via a lateral neck incision. Ann Chir 1999;53:302–6
32Ikeda, Y, Takami, H. Endoscopic parathyroidectomy. Biomed Pharmacother 2000;54(suppl 1):5256
33Kuriansky, J, Fernandez-Cruz, L. Preliminary experiences with endoscopic parathyroidectomy [in Hebrew]. Harefuah 2000;138:94–6
34Henry, JF, Sebag, F, Tamagnini, P, Forman, C, Silaghi, H. Endoscopic parathyroid surgery: results of 365 consecutive procedures. World J Surg 2004;28:1219–23
35Hessman, O, Westerdahl, J, Al-Suliman, N, Christiansen, P, Hellman, P, Bergenfelz, A. Randomized clinical trial comparing open with video-assisted minimally invasive parathyroid surgery for primary hyperparathyroidism. Br J Surg 2010;97:177–84
36Bergenfelz, A, Kamigiesser, V, Zielke, A, Nies, C, Rothmund, M. Conventional bilateral cervical exploration versus open minimally invasive parathyroidectomy under local anaesthesia for primary hyperparathyroidism. Br J Surg 2005;92:190–7
37Barczynski, M, Cichon, S, Konturek, A, Cichon, W. Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial. World J Surg 2006;30:721–31
38Barczynski, M, Cichon, S, Konturek, A, Cichon, W, Wierzchowski, W. Comparison of two techniques of minimally invasive parathyroidectomy: video-assisted (MIVAP) and open (OMIP). Pol J Surg 2007;79:1264–79
39Miccoli, P, Berti, P, Materazzi, G, Ambrosini, CE, Fregoli, L, Donatini, G. Endoscopic bilateral neck exploration versus quick intraoperative parathormone assay (qPTHa) during endoscopic parathyroidectomy: a prospective randomized trial. Surg Endosc 2008;22:398400
40Slepavicius, A, Beisa, V, Janusonis, V, Strupas, K. Focused versus conventional parathyroidectomy for primary hyperparathyroidism: a prospective, randomized, blinded trial. Langenbecks Arch Surg 2008;393:659–66
41Walgenbach, S, Junginger, T. Results of bilateral surgical technique in primary hyperparathyroidism [in German]. Zentralbl Chir 2001;126:254–60
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The Journal of Laryngology & Otology
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  • EISSN: 1748-5460
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