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Published in: Surgical Endoscopy 4/2017

01-04-2017

Prevertebral cervical approach: a pure endoscopic surgical technique for posterior mediastinum parathyroid adenomas

Authors: Juan Manuel Martos-Martínez, Cristina Sacristán-Pérez, Marina Pérez-Andrés, Virginia María Durán-Muñoz-Cruzado, Verónica Pino-Díaz, Francisco Javier Padillo-Ruiz

Published in: Surgical Endoscopy | Issue 4/2017

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Abstract

Background

Parathyroid gland mediastinal ectopia is an unusual but challenging condition in surgical management of hyperparathyroidism. Posterior mediastinum parathyroid ectopia is rare, and glands need to be removed either with a broad open cervical or thoracic approach. In recent years, several minimally invasive approaches to mediastinal parathyroid glands have been described, but for posterior mediastinum adenomas, proposed techniques are transthoracic.

Methods

The aim of this paper is to describe, to our best knowledge for the first time, a standardized pure endoscopic cervical technique to approach posterior mediastinal parathyroid adenomas which we have used in three patients.

Results

The technique was applied in three patients which excellent surgical, postoperative, and cosmetic results.

Conclusions

Endoscopic prevertebral approach is a feasible, sure and inexpensive standardized pure endoscopic cervical approach to posterior mediastinal parathyroid adenomas, which may result in a less aggressive surgical option when compared with thoracic approaches.
Literature
1.
go back to reference Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP (1999) A 10-year prospective study of primary hyperthyroidism with or without parathyroid surgery. N Engl J Med 34:1249–1255CrossRef Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP (1999) A 10-year prospective study of primary hyperthyroidism with or without parathyroid surgery. N Engl J Med 34:1249–1255CrossRef
2.
go back to reference Kim JY, Hofstetter WL (2010) Tumors of the Mediastinum and Chest Wall. Surg Clin N Am 90:1019–1040CrossRefPubMed Kim JY, Hofstetter WL (2010) Tumors of the Mediastinum and Chest Wall. Surg Clin N Am 90:1019–1040CrossRefPubMed
3.
go back to reference Assalia A, Inabnet WB (2004) Endoscopic parathyroidectomy. Otolaryngol Clin N Am 37:871–886CrossRef Assalia A, Inabnet WB (2004) Endoscopic parathyroidectomy. Otolaryngol Clin N Am 37:871–886CrossRef
4.
go back to reference Nwariaku FE, Snyder WH, Burkey SH, Watumull L, Mathews D (2005) Inframanubrial parathyroid glands in patients with primary hyperparathyroidism: alternatives to sternotomy. World J Surg 29:491–494CrossRefPubMed Nwariaku FE, Snyder WH, Burkey SH, Watumull L, Mathews D (2005) Inframanubrial parathyroid glands in patients with primary hyperparathyroidism: alternatives to sternotomy. World J Surg 29:491–494CrossRefPubMed
5.
go back to reference Ogawa T, Tsuji E, Kanauchi H, Yamada K, Mimura Y, Kaminishi M (2007) Excision of postesophageal parathyroid adenoma in posterior mediastinum with intraoperative 99mTechnetium sestamibi scanning. Ann Thorac Surg 84:1754–1756CrossRefPubMed Ogawa T, Tsuji E, Kanauchi H, Yamada K, Mimura Y, Kaminishi M (2007) Excision of postesophageal parathyroid adenoma in posterior mediastinum with intraoperative 99mTechnetium sestamibi scanning. Ann Thorac Surg 84:1754–1756CrossRefPubMed
6.
go back to reference Nakai K, Fujii H, Maeno K, Nishida K, Kobayashi A, Shin J, Hara S, Nishi S (2014) A case of parathyroid adenoma adjacent to the thoracic spine in a hemodialysis patient. Clin Nephrol 81:52–57CrossRefPubMed Nakai K, Fujii H, Maeno K, Nishida K, Kobayashi A, Shin J, Hara S, Nishi S (2014) A case of parathyroid adenoma adjacent to the thoracic spine in a hemodialysis patient. Clin Nephrol 81:52–57CrossRefPubMed
7.
go back to reference Yun JS, Nam KH, Chung WY, Park CS (2008) Giant posterior mediastinal parathyroid adenoma. Thyroid 18:475–476CrossRefPubMed Yun JS, Nam KH, Chung WY, Park CS (2008) Giant posterior mediastinal parathyroid adenoma. Thyroid 18:475–476CrossRefPubMed
8.
go back to reference Moreno P, Francos JM, Shaha A, Bosch A, de Lama E, Rafecas A, Jaurrieta E (2007) Intercostal Video-Assisted Mediastinal Surgery through an intercostal window (IVAMS): a simpler approach to perform mediastinal parathyroidectomy. Surgery 142:410–413CrossRefPubMed Moreno P, Francos JM, Shaha A, Bosch A, de Lama E, Rafecas A, Jaurrieta E (2007) Intercostal Video-Assisted Mediastinal Surgery through an intercostal window (IVAMS): a simpler approach to perform mediastinal parathyroidectomy. Surgery 142:410–413CrossRefPubMed
9.
go back to reference Inabnet WB, Chu CA (2003) Transcervical endoscopic-assisted mediastinal parathyroidectomy with intraoperative parathyroid hormone monitoring. Surg Endosc 17:1678CrossRefPubMed Inabnet WB, Chu CA (2003) Transcervical endoscopic-assisted mediastinal parathyroidectomy with intraoperative parathyroid hormone monitoring. Surg Endosc 17:1678CrossRefPubMed
10.
go back to reference Sukumar MS, Komanapalli CB, Cohen JI (2006) Minimally invasive management of the mediastinal parathyroid adenoma. Laryngoscope 116:482–487CrossRefPubMed Sukumar MS, Komanapalli CB, Cohen JI (2006) Minimally invasive management of the mediastinal parathyroid adenoma. Laryngoscope 116:482–487CrossRefPubMed
11.
go back to reference Iacobone M, Mondi I, Viel G, Citton M, Tropea S, Frego M, Favia G (2010) The results of surgery for mediastinal parathyroid tumors: a comparative study of 63 patients. Langenbecks Arch Surg 395:947–953CrossRefPubMed Iacobone M, Mondi I, Viel G, Citton M, Tropea S, Frego M, Favia G (2010) The results of surgery for mediastinal parathyroid tumors: a comparative study of 63 patients. Langenbecks Arch Surg 395:947–953CrossRefPubMed
12.
go back to reference Knight R, Ratzer ER, Fenoglio ME, Moore JT (1997) Thoracoscopic excision of mediastinal parathyroid adenomas: a report of two cases and review of the literature. Am Coll Surg 185:481–485CrossRef Knight R, Ratzer ER, Fenoglio ME, Moore JT (1997) Thoracoscopic excision of mediastinal parathyroid adenomas: a report of two cases and review of the literature. Am Coll Surg 185:481–485CrossRef
13.
go back to reference Lesser T, Bartel M (1999) Videothoracoscopic excision of mediastinal parathyroid adenoma. Eur J Surg 165:395–397CrossRefPubMed Lesser T, Bartel M (1999) Videothoracoscopic excision of mediastinal parathyroid adenoma. Eur J Surg 165:395–397CrossRefPubMed
14.
go back to reference Randone B, Costi R, Scatton O, Fulla Y, Bertagna X, Soubrane O, Bonnichon P (2010) Thoracoscopic removal of mediastinal parathyroid glands: a critical appraisal of an emerging technique. Ann Surg 251:717–721CrossRefPubMed Randone B, Costi R, Scatton O, Fulla Y, Bertagna X, Soubrane O, Bonnichon P (2010) Thoracoscopic removal of mediastinal parathyroid glands: a critical appraisal of an emerging technique. Ann Surg 251:717–721CrossRefPubMed
15.
go back to reference Kumar A, Kumar S, Aggarwal S, Kumar R, Tandon N (2002) Thoracoscopy: the preferred method for excision of mediastinal parathyroids. Surg Laparosc Endosc Percutan Tech 12:295–300CrossRefPubMed Kumar A, Kumar S, Aggarwal S, Kumar R, Tandon N (2002) Thoracoscopy: the preferred method for excision of mediastinal parathyroids. Surg Laparosc Endosc Percutan Tech 12:295–300CrossRefPubMed
16.
go back to reference Iihara M, Suzuki R, Kawamata A (2012) Thoracoscopic removal of mediastinal parathyroid lesions: selection of surgical approach and pitfalls of preoperative and intraoperative localization. World J Surg 36:1327–1334CrossRefPubMed Iihara M, Suzuki R, Kawamata A (2012) Thoracoscopic removal of mediastinal parathyroid lesions: selection of surgical approach and pitfalls of preoperative and intraoperative localization. World J Surg 36:1327–1334CrossRefPubMed
17.
go back to reference Wei B, Inabnet W, Lee JA, Sonett JR (2011) Optimizing the minimally invasive approach to mediastinal parathyroid adenomas. Ann Thorac Surg 92:1012–1017CrossRefPubMed Wei B, Inabnet W, Lee JA, Sonett JR (2011) Optimizing the minimally invasive approach to mediastinal parathyroid adenomas. Ann Thorac Surg 92:1012–1017CrossRefPubMed
18.
go back to reference Wild JL, Weigel T, Chen H (2006) The need for intraoperative parathyroid hormone monitoring during radioguided parathyroidectomy by video-assisted thoracoscopy (VATS). Clin Nucl Med 31:9–12CrossRefPubMed Wild JL, Weigel T, Chen H (2006) The need for intraoperative parathyroid hormone monitoring during radioguided parathyroidectomy by video-assisted thoracoscopy (VATS). Clin Nucl Med 31:9–12CrossRefPubMed
19.
go back to reference O’Herrin JK, Weigel T, Wilson M, Chen H (2002) Radioguided parathyroidectomy via VATS combined with intraoperative parathyroid hormone testing: the surgical approach of choice for patients with mediastinal parathyroid adenomas? J Bone Miner Res 17:1368–1371CrossRefPubMed O’Herrin JK, Weigel T, Wilson M, Chen H (2002) Radioguided parathyroidectomy via VATS combined with intraoperative parathyroid hormone testing: the surgical approach of choice for patients with mediastinal parathyroid adenomas? J Bone Miner Res 17:1368–1371CrossRefPubMed
20.
go back to reference Minamiya Y, Saito H, Ito M, Motoyama S, Katayose Y, Ogawa J (2009) Radio-guided thoracoscopic surgery with 99mTc-methoxy-isobutylisonitrile for treating an ectopic mediastinal parathyroid adenoma in an adolescent girl. Gen Thorac Cardiovasc Surg 57:657–659CrossRefPubMed Minamiya Y, Saito H, Ito M, Motoyama S, Katayose Y, Ogawa J (2009) Radio-guided thoracoscopic surgery with 99mTc-methoxy-isobutylisonitrile for treating an ectopic mediastinal parathyroid adenoma in an adolescent girl. Gen Thorac Cardiovasc Surg 57:657–659CrossRefPubMed
21.
go back to reference Alesina PF, Moka D, Mahlstedt J, Walz MK (2008) Thoracoscopic removal of mediastinal hyperfunctioning parathyroid glands: personal experience and review of the literature. World J Surg 32:224–231CrossRefPubMed Alesina PF, Moka D, Mahlstedt J, Walz MK (2008) Thoracoscopic removal of mediastinal hyperfunctioning parathyroid glands: personal experience and review of the literature. World J Surg 32:224–231CrossRefPubMed
22.
go back to reference Lu HI, Chou FF, Chi SY, Huang SC (2015) Thoracoscopic removal of hypertrophic mediastinal parathyroid glands in recurrent secondary hyperparathyroidism. World J Surg 39:400–409CrossRefPubMed Lu HI, Chou FF, Chi SY, Huang SC (2015) Thoracoscopic removal of hypertrophic mediastinal parathyroid glands in recurrent secondary hyperparathyroidism. World J Surg 39:400–409CrossRefPubMed
23.
go back to reference Profanter C, Schmid T, Prommegger R, Bale R, Sauper T, Bodner J (2004) Robot-assisted mediastinal parathyroidectomy. Surg Endosc 18(5):868–870CrossRefPubMed Profanter C, Schmid T, Prommegger R, Bale R, Sauper T, Bodner J (2004) Robot-assisted mediastinal parathyroidectomy. Surg Endosc 18(5):868–870CrossRefPubMed
24.
go back to reference Brunaud L, Ayav A, Bresler L, Schjött B (2008) Da Vinci robot-assisted thoracoscopy for primary hyperparathyroidism: a new application in endocrine surgery. J Chir (Paris) 145:165–167CrossRef Brunaud L, Ayav A, Bresler L, Schjött B (2008) Da Vinci robot-assisted thoracoscopy for primary hyperparathyroidism: a new application in endocrine surgery. J Chir (Paris) 145:165–167CrossRef
25.
go back to reference Harvey A, Bohacek L, Neumann D, Mihaljevic T, Berber E (2011) Robotic thoracoscopic mediastinal parathyroidectomy for persistent hyperparathyroidism: case report and review of the literature. Surg Laparosc Endosc Percutan Tech. doi:10.1097/SLE.0b013e31820607be PubMed Harvey A, Bohacek L, Neumann D, Mihaljevic T, Berber E (2011) Robotic thoracoscopic mediastinal parathyroidectomy for persistent hyperparathyroidism: case report and review of the literature. Surg Laparosc Endosc Percutan Tech. doi:10.​1097/​SLE.​0b013e31820607be​ PubMed
26.
go back to reference Karagkounis G, Uzun DD, Mason DP, Murthy SC, Berber E (2014) Robotic surgery for primary hyperparathyroidism. Surg Endosc 28:2702–2707CrossRefPubMed Karagkounis G, Uzun DD, Mason DP, Murthy SC, Berber E (2014) Robotic surgery for primary hyperparathyroidism. Surg Endosc 28:2702–2707CrossRefPubMed
27.
go back to reference Bilezikian JP, Khan KA, Potts JT (2009) Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop. J Clin Endocrinol Metab 94:335–339CrossRefPubMedPubMedCentral Bilezikian JP, Khan KA, Potts JT (2009) Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop. J Clin Endocrinol Metab 94:335–339CrossRefPubMedPubMedCentral
Metadata
Title
Prevertebral cervical approach: a pure endoscopic surgical technique for posterior mediastinum parathyroid adenomas
Authors
Juan Manuel Martos-Martínez
Cristina Sacristán-Pérez
Marina Pérez-Andrés
Virginia María Durán-Muñoz-Cruzado
Verónica Pino-Díaz
Francisco Javier Padillo-Ruiz
Publication date
01-04-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5197-y

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