Top

Published in:

01-11-2009

Video-Assisted Minimally Invasive Parathyroidectomy: Benefits and Long-Term Results

Authors: Celestino P. Lombardi, Marco Raffaelli, Emanuela Traini, Carmela De Crea, Salvatore M. Corsello, Rocco Bellantone

Published in: World Journal of Surgery | Issue 11/2009

Abstract

Background

In recent years several endoscopic and video-assisted techniques for parathyroidectomy have been described. The role of these techniques, with respect to time-honored conventional surgery, has been largely debated. This paper was designed to review the evidence, and make the recommendations, for the video-assisted/endoscopic approach to parathyroidectomy.

Methods

A database search was conducted in PubMed from which abstracts were screened matching our definition. Publications were further assessed and assigned their respective level of evidence. Additional data were obtained on the basis of our personal experience.

Results

Thirty-eight mainly retrospective studies have been published. Only four small, prospective, randomized trials, providing level II evidence, and one retrospective case-control comparative study, providing level IV evidence, have been found. Minimally invasive video-assisted parathyroidectomy (MIVAP) has emerged as one of the leading techniques. To date several randomized studies have shown that MIVAP is an efficacious and feasible procedure with the same complications rate as conventional surgery. Moreover, MIVAP seems to have significant advantages in terms of cosmetic result, postoperative pain and recovery, and patient satisfaction.

Conclusions

From an evidence-based point of view, MIVAP should be considered a valid and validated option for the treatment of sporadic primary hyperparathyroidism sustained by a well-localized, single adenoma. Its role for the treatment of multiglandular diseases (familial hyperparathyroidism, secondary hyperparathyroidism) needs to be better clarified.

Lee JA, Inabnet WB III (2005) The surgeon’s armamentarium to the surgical treatment of primary hyperparathyroidism. J Surg Oncol 89:130–135PubMedCrossRef

Duh QY (1997) Surgical approach to primary hyperparathyroidism (bilateral approach). In: Clark OH, Duh QY (eds) Textbook of endocrine surgery. Saunders, Philadelphia, pp 357–363

Tibblin S, Bondeson AG, Ljunberg O (1982) Unilateral parathyroidectomy due to single adenoma. Ann Surg 195:245–251PubMedCrossRef

Bergenfelz A, Lindblom P, Tibblin S et al (2002) Unilateral versus bilateral neck exploration for primary hyperparathyroidism: a prospective randomized controlled trial. Ann Surg 236:543–551PubMedCrossRef

Russel CF, Dolan SJ, Laird JD (2006) Randomized clinical trial comparing scan-directed unilateral versus bilateral exploration for parathyroidectomy due to solitary adenoma. Br J Surg 93:418–421CrossRef

Tang T, Dolan S, Robinson B et al (2007) Does the surgical approach affect quality of life outcomes? A comparison of minimally invasive parathyroidectomy with open parathyroidectomy. Int J Surg 5:17–22PubMedCrossRef

Palazzo FF, Delbridge LW (2004) Minimally-access/minimally invasive parathyroidectomy for primary hyperparathyroidism. Surg Clin North Am 84:717–734PubMedCrossRef

Sosa JA, Udelsman R (2003) Minimally invasive parathyroidectomy. Surg Oncol 12:125–134PubMedCrossRef

Norman J, Chheda H (1997) Minimally invasive parathyroidectomy facilitated by intraoperative nuclear mapping. Surgery 122:998–1004PubMedCrossRef

10.

Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875PubMedCrossRef

11.

Miccoli P, Bendinelli C, Conte M et al (1998) Endoscopic parathyroidectomy by a gasless approach. J Laparoendosc Adv Surg Tech A 8:189–194PubMedCrossRef

12.

Henry JF, Defechereux T, Gramatica L et al (1999) Minimally invasive videoscopic parathyroidectomy by lateral approach. Langenbecks Arch Surg 384:298–301PubMedCrossRef

13.

Ikeda Y, Takami H (2000) Endoscopic parathyroidectomy. Biomed Pharmacother 54(Suppl 1):52s–56sPubMedCrossRef

14.

Ikeda Y, Takami H, Niimi M et al (2002) Endoscopic total parathyroidectomy by the anterior chest approach for renal hyperparathyroidism. Surg Endosc 16:320–322PubMedCrossRef

15.

Ikeda Y, Takami H, Tajima G et al (2002) Total endoscopic parathyroidectomy. Biomed Pharmacother 56(Suppl 1):22s–25sPubMedCrossRef

16.

Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for best cosmesis. Surg Laparoendosc Percutan Techn 10:1–4

17.

Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340PubMedCrossRef

18.

Takami H, Ikeda Y, Wada N (2000) Surgical management of primary hyperparathyroidism. Biomed Pharmacother 54(Suppl 1):17–20CrossRef

19.

Takami H, Ikeda Y, Kan S et al (2002) New operative strategies in primary hyperparathyroidism. Asian J Surg 25:184–187PubMed

20.

Kitano H, Fujimura M, Hirano M et al (2000) Endoscopic surgery for a parathyroid functioning adenoma resection with the neck region-lifting method. Otolaryngol Head Neck Surg 123:465–466PubMedCrossRef

21.

Okido M, Shimizu S, Kuroki S et al (2001) Video-assisted parathyroidectomy for primary hyperparathyroidism: a new approach involving a skin-lifting method. Surg Endosc 15:1120–1123PubMedCrossRef

22.

Usui Y, Sasaki T, Kimura K et al (2001) Gasless endoscopic thyroid and parathyroid surgery using a new retractor. Surg Today 31:939–941PubMedCrossRef

23.

Sackett DL (1989) Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95(Suppl 2):2s–4sPubMed

24.

Heinrich S, Schäffer M, Rousson V et al (2006) Evidence-based treatment of acute pancreatitis: a look et established paradigms. Ann Surg 243:154–168PubMedCrossRef

25.

Norman J, Albrink MH (1997) Minimally invasive videoscopic parathyroidectomy: a feasibility study in dogs and humans. J Laparoendosc Adv Surg Tech A 7:301–306PubMedCrossRef

26.

Naitoh T, Gagner M, Garcia-Ruiz A et al (1998) Endoscopic endocrine surgery in the neck. An initial report of endoscopic subtotal parathyroidectomy. Surg Endosc 12:202–206PubMedCrossRef

27.

Miccoli P, Bendinelli C, Vignali E et al (1998) Endoscopic parathyroidectomy: report of an initial experience. Surgery 124:1079–1080CrossRef

28.

Chowbey PK, Mann V, Khullar R et al (1999) Endoscopic neck surgery: expanding horizons. J Laparoendosc Adv Surg Tech A 9:397–400PubMedCrossRef

29.

Gauger PG, Reeve TS, Delbridge LW (1999) Endoscopically assisted minimally invasive parathyroidcetomy. Br J Surg 86:1563–1566PubMedCrossRef

30.

Dralle H, Lorenz K, Nguyen-Thann P (1999) Minimally invasive video-assisted parathyroidectomy: selective approach to localized single gland adenoma. Langenbecks Arch Surg 384:556–562PubMedCrossRef

31.

Miccoli P, Bendinelli C, Berti P et al (1999) Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized trial. Surgery 126:1117–1121PubMedCrossRef

32.

Miccoli P, Berti P, Conte M et al (2000) Minimally invasive video-assisted parathyroidectomy: lesson learned from 137 cases. J Am Coll Surg 191:613–618PubMedCrossRef

33.

Okido M, Shimizu S, Kuroki S et al (2001) Video-assisted parathyroidectomy by a skin-lifting method for primary hyperparathyroidism. JSLS 5:197–200PubMed

34.

Mourad M, Ngongang C, Saab N et al (2001) Video-assisted neck exploration for primary and secondary hyperparathyroidism. Surg Endosc 15:1112–1115PubMedCrossRef

35.

De Pasquale L, Bianchi P, Barabino M et al (2001) Radio-guided video-assisted parathyroidectomy. A preliminary report. Surg. Endosc 15:1456–1458PubMed

36.

Henry JF, Iacobone M, Mirallie E et al (2001) Indications and results of video-assisted parathyroidectomy by a lateral approach in patients with primary hyperparathyroidism. Surgery 130:999–1003PubMedCrossRef

37.

Henry JF, Raffaelli M, Iacobone M et al (2001) Video-assisted parathyroidectomy via the lateral approach vs conventional surgery in the treatment of sporadic primary hyperparathyroidism. Surg Endosc 15:1116–1119PubMedCrossRef

38.

Hallfeldt KKJ, Trupka A, Gallwas J et al (2001) Minimally invasive video-assisted parathyroidectomy. Early experience using an anterior approach. Surg Endosc 15:409–412PubMedCrossRef

39.

Lorenz K, Miccoli P, Monchik JM et al (2001) Minimally invasive video-assisted parathyroidectomy: multiinstitutional study. World J Surg 25:704–707PubMedCrossRef

40.

Lorenz K, Phuong NT, Dralle H (2002) Diversification of minimally invasive parathyroidectomy for primary hyperparathyroidism: minimally invasive video-assisted parahyroidectomy and minimally invasive open videoscopically magnified parathyroidectomy with local anesthesia. World J Surg 26:1066–1070PubMedCrossRef

41.

Hallfeldt KKJ, Trupka A, Gallwas J et al (2002) Minimally invasive video-assisted parathyroidectomy and intraoperative parathyroid hormone monitoring. Surg Endosc 16:1759–1763PubMedCrossRef

42.

Inabnet WBIII, Dakin GF, Haber RS et al (2002) Targeted parathyroidectomy in the era of intraoperative parathormone monitoring. World J Surg 26:921–925PubMedCrossRef

43.

Miccoli P, Berti P, Materazzi G et al (2003) Minimally invasive video assisted parathyroidectomy (MIVAP). Eur J Surg Oncol 29:188–190PubMedCrossRef

44.

Berti P, Materazzi G, Picone A et al (2003) Limits and drawbacks of video-assisted parathyroidectomy. Br J Surg 90:743–747PubMedCrossRef

45.

Henry JF, Sebag F, Tamagnini P et al (2004) Endoscopic parathyroid surgery: results of 365 consecutive procedures. World J Surg 28:1219–1223PubMedCrossRef

46.

Miccoli P, Berti P, Materazzi G et al (2004) Results of video-assisted parathyroidectomy: single institution’s six-year experience. World J Surg 28:1216–1223PubMedCrossRef

47.

Maweja S, Sebag F, Hubbard J et al (2004) Immediate and medium-term results of intraoperative parathyroid hormone monitoring during video-assisted parathyroidectomy. Arch Surg 139:1301–1303PubMedCrossRef

48.

Miccoli P, Barellino L, Monchik JM et al (2005) Randomized clinical trial comparing regional and general anesthesia in minimally invasive video-assisted parathyroidectomy. Br J Surg 92:814–818PubMedCrossRef

49.

Miccoli P, Minuto M, Cetani F et al (2005) Familial parathyroid hyperplasia: is there a place for minimally invasive surgery? Description of the first treated case. J Endocrinol Invest 28:942–943PubMed

50.

Prosst RL, Gahlen J, Schnuelle P et al (2006) Fluorescence guided minimally invasive parathyroidectomy: a novel surgical therapy for secondary hyperparathyroidism. Am J Kidney Dis 48:327–331PubMedCrossRef

51.

Barczyński M, Chicoń S, Konturek A et al (2006) Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial. World J Surg 30:721–731PubMedCrossRef

52.

Murphy AD, Andrews EJ, Ishtiaq A et al (2007) Sestamibi scan-directed, minimally invasive video-assisted parathyroidectomy: an effective treatment for solitary parathyroid adenoma. Ir J Med Sci 176:283–287PubMedCrossRef

53.

Henry JF, Sebag F, Cherenko M et al (2008) Endoscopic parathyroidectomy: why and when? World J Surg 32:2509–2515PubMedCrossRef

54.

Barbaros U, Erbil Y, Yildirim A et al (2008) Minimally invasive video-assisted subtotal parathyroidectomy with thymectomy for secondary hyperparathyroidism. Langenbecks Arch Surg 23; Epub ahead of print

55.

Miccoli P, Berti P, Materazzi G et al (2008) Endoscopic bilateral neck exploration versus (qPTHa) during endoscopic parathyroidectomy: a prospective randomized trial. Surg. Endosc 22:398–400PubMedCrossRef

56.

Lombardi CP, Raffaelli M, Traini E et al (2008) Advantages of a video-assisted approach to parathyroidectomy. ORL J Otorhinolaryngol Relat Spec 70:313–318PubMed

57.

Assalia A, Inabnet WB (2004) Endoscopic parathyroidectomy. Otolaryngol Clin North Am 37:871–886PubMedCrossRef

58.

Henry JF, Defechereux T, Gramatica L et al (1999) Endoscopic parathyroidectomy via a lateral neck incision. Ann Chir 53:302–306PubMed

59.

Henry JF, Sebag F, Maweja S et al (2003) Video-assisted parathyroidectomy in the management of patients with primary hyperparathyroidism. Ann Chir 128:379–384PubMedCrossRef

60.

Henry JF, Misso C, Sebag F et al (2003) Video-assisted minimally invasive parathyroidectomy with lateral approach in patients with primary hyperparathyroidism. Ann Ital Chir 74:401–405PubMed

61.

Henry JF, Sebag F, Misso C et al (2004) New surgical approaches to primary hyperparathyroidism. Rev Med Suisse Romande 124:93–95PubMed

62.

Henry JF, Sebag F (2006) Lateral endoscopic approach for thyroid and parathyroid surgery. Ann Chir 131:51–56PubMedCrossRef

63.

Henry JF (2008) Minimally invasive thyroid and parathyroid surgery is not a question of length of the incision. Langenbecks Arch Surg 393:621–626PubMedCrossRef

64.

Suzuki S, Fukushima T, Ami H et al (2002) Video-assisted parathyroidectomy. Biomed Pharmacother 56(Suppl 1):18s–21sPubMedCrossRef

65.

Kitagawa W, Shimizu K, Kumita S et al (2002) Radioguided parathyroidectomy for primary hyperparathyroidism combined with video-assisted surgery using the solid-state multi-crystal gamma camera. J Surg Oncol 80:173–175PubMedCrossRef

66.

Gottleib A, Sprung J, Zheng X-M et al (1997) Massive subcutaneous emphysema and severe hypercarbia in a patient during endoscopic transcervical parathyroidectomy using carbon dioxide insufflations. Anesth Analg 84:1154–1156CrossRef

67.

Salihoglu Z, Demiroluk S, Demirkiran O et al (2003) Videoscopic parathyroidectomy: gaseous or gasless technique? Anesth Analg 96:1819

68.

Stalberg P, Sidhu S, Sywak M et al (2006) Intraoperative parathyroid hormone measurement during minimally invasive parathyroidectomy: does it “value-add” to decision-making? J Am Coll Surg 203:1–6PubMedCrossRef

69.

Carneiro-Pla DM, Solorzano CC, Irvin GLIII (2006) Consequences of targeted parathyroidectomy guided by localization studies without intraoperative parathyroid hormone monitoring. J Am Coll Surg 202:715–722PubMedCrossRef

70.

Barczynski M, Konturek A, Cichon S et al (2007) Intraoperative parathyroid hormone assay improves outcomes of minimally invasive parathyroidectomy. Mainly in patients with a presumed solitary parathyroid adenoma and missing concordance of preoperative imaging. Clin Endocrinol 66:878–885CrossRef

71.

Di Stasio E, Carrozza C, Lombardi CP et al (2007) Parathyroidectomy monitored by intra-operative PTH: the relevance of the 20 min end-point. Clin Biochem 40:595–603PubMedCrossRef

72.

Lombardi CP, Raffaelli M, Traini E et al (2008) Intraoperative PTH monitoring during parathyroidectomy: the need for stricter criteria to detect multiglandular disease. Langenbecks Arch Surg 393:639–645PubMedCrossRef

Title: Video-Assisted Minimally Invasive Parathyroidectomy: Benefits and Long-Term Results
Authors: Celestino P. Lombardi
Marco Raffaelli
Emanuela Traini
Carmela De Crea
Salvatore M. Corsello
Rocco Bellantone
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 11/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-009-9931-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Video-Assisted Minimally Invasive Parathyroidectomy: Benefits and Long-Term Results

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2009

Lithium Therapy and Hyperparathyroidism: An Evidence-Based Assessment

Parathyroid Carcinoma: Etiology, Diagnosis, and Treatment

Inhibition of the PI3K Pathway Suppresses Hormonal Secretion and Limits Growth in Pheochromocytoma Cells

Comparison of Four Staging Systems of Lymph Node Metastasis in Gastric Cancer

Implementing Fast-Track Protocol for Colorectal Surgery: A Prospective Randomized Clinical Trial

Comparison of Invasiveness Between Laparoscopy-Assisted Total Gastrectomy and Open Total Gastrectomy