Focused parathyroidectomy through an open‐lateral approach for treating solitary parathyroid adenoma. Issue 4 (November 2015)

• Record Type: Journal Article
• Authors: Yang, Zhili; Guo, Minggao; Wu, Bo; Zheng, Qi; Fan, Youben
• Is Part Of: Surgical practice. Volume 19:Issue 4(2015:Nov.)
• Page Start: 160
• Page End: 165
• Publication Date: 2015-11
• Subjects: Surgery -- Periodicals; Operations, Surgical -- Periodicals; 617.005
• DOI: 10.1111/1744-1633.12149
• Languages: English
• ISSNs: 1744-1625

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ash12149-sec-0001" sec-type="section"> <title>Aim</title> <p>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.</p> </sec> <sec id="ash12149-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p>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.</p> </sec> <sec id="ash12149-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> > 0.05). Compared to conventional parathyroidectomy, the focused approach was more advantageous, with shorter operative times, smaller scar lengths and shorter hospital stays (<italic>P</italic> < 0.05).</p> </sec> <sec id="ash12149-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>