Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: A prospective randomized study

Background. Several studies demonstrated the feasibility of minimally invas ive parathyroidectomy as a treatment for primary hyperparathyroidism. We co mpared its results with those of traditional surgery in a prospective rando mized study. Methods. From March to November 1998, 38 patients eligible for video-assist ed parathyroidectomy (VAP) were referred to us. They were randomly divided into 2 groups: patients of group A underwent a conventional cervicotomy wit h bilateral exploration and frozen section of the removed adenoma; patients of group B underwent VAP with intraoperative measurement of parathyroid ho rmone, operative time, postoperative pain, fever and hypocalcemia, cosmetic result, and costs were compared. Two cases of VAP were performed with loco regional anesthesia. Results, Groups A (18 patients) and B (20 patients) were statistically bala nced. Operative time was significantly shorter in group B (57 vs 70 minutes ). Cosmetic result was significantly better in group B, which also experien ced less postoperative pain (P < .05). No cases of persistent primary hyper parathyroidism were present in either group, but recurrent laryngeal nerve palsy occurred in I patient in group B. Conclusions, Compared with conventional surgery, VAP is associated with a s horter operative time, a better cosmetic result, and a less painful postope rative course.