Paratiroidectomia mini-invasiva video-assistita e monitoraggio intraoperatorio del paratormone

Dobrinja, Chiara and Stenner, Elisabetta and Trevisan, Giuliano and Micheli, W. and Biasioli, Bruno and Liguori, Gennaro (2010) Paratiroidectomia mini-invasiva video-assistita e monitoraggio intraoperatorio del paratormone. Il giornale di chirurgia, 31 (6/7). pp. 319-321. ISSN 1971-145X

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Abstract

Background. Aim of this study is to analyze our preliminary results from minimally invasive video-assisted parathyroidectomy (MIVAP) and to evaluate the clinical impact of intraoperative measurements of intact parathyroid hormone (PTHIO). Patients and methods. MIVAP by an anterior approach was proposed for patients with sporadic primary hyperparathyroidism pHPT and one unequivocally enlarged parathyroid gland on preoperative ultrasound and 99mTc-SestaMIBI scintigraphy. We used an operative technique first described by Miccoli in 1997, without carbon dioxide insufflation. Quick parathyroid hormone immunochemiluminometric assay (qPTHa) was performed intraoperatively during all surgical procedures. Age, operative times, pathologic findings, postoperative pain, calcemia, length of hospital stay, cosmetic results, and complications were retrospectively analyzed. Results. From October 2006 to December 2009, MIVAP was proposed for 28 of 40 (70%). Mean operative time was 65 minutes. Postoperative complications included 4 (12.9%) transient hypocalcemia and one (3.22%) transient nerve palsy with complete recovery. No definitive laryngeal nerve palsies, no definitive hypocalcemias, no persistent pHPT and no recurrent pHPT were observed. The cosmetic result was excellent in all cases. Conclusions. Our preliminary results demonstrate that MIVAP for localized single-gland adenoma, after adequate training, seems to be feasible with significant advantages, especially in terms of cosmetic results, postoperative pain, and postoperative recovery, if performed by dedicated team, with a sufficient and specific activity volume.

Item Type:	Article
Uncontrolled Keywords:	Paratiroidectomia video-assistita mini-invasiva - Paratormone - Monitoraggio intraoperatorio
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	12 Apr 2016 15:21
Last Modified:	12 Apr 2016 15:21
URI:	http://eprints.bice.rm.cnr.it/id/eprint/6928

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