P. Miccoli et al., Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: A prospective randomized study, SURGERY, 126(6), 1999, pp. 1117-1121
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.