BACKGROUND: The durability of minimally invasive parathyroidectomy (MIP) has been questioned, and some advocate for routine open parathyroidectomy (OP). This study compared outcomes between patients treated with MIP compared with OP for primary hyperparathyroidism (PHPT). METHODS: A retrospective review was performed to identify cases of PHPT with single adenomas (SA) between 2001 and 2011. Operations were classified as OP when both sides were explored. Kaplan-Meier estimates were plotted and compared by the log-rank test. RESULTS: We analyzed 1,083 patients with PHPT with SA; 928 (85.7%) were MIP and 155 (14.3%) were OP. There was no difference in the rates of persistence (0.2% MIP vs 0% OP, P = .61) or recurrence (2.5% MIP vs 1.9% OP, P = .68) between the 2 groups. The Kaplan-Meier estimates did, however, began to separate beyond 8 years' follow-up. The OP group did experience a greater incidence of transient hypocalcemia postoperatively (1.9% vs 0.1%, P = .01). CONCLUSION: MIP appears equivalent to OP in single-gland disease. Although patients undergoing OP experienced more transient hypocalcemia, patients undergoing MIP appear to have a greater long-term recurrence rate. Therefore, proper patient selection and counseling of these risks is necessary for either approach.
BACKGROUND: The durability of minimally invasive parathyroidectomy (MIP) has been questioned, and some advocate for routine open parathyroidectomy (OP). This study compared outcomes between patients treated with MIP compared with OP for primary hyperparathyroidism (PHPT). METHODS: A retrospective review was performed to identify cases of PHPT with single adenomas (SA) between 2001 and 2011. Operations were classified as OP when both sides were explored. Kaplan-Meier estimates were plotted and compared by the log-rank test. RESULTS: We analyzed 1,083 patients with PHPT with SA; 928 (85.7%) were MIP and 155 (14.3%) were OP. There was no difference in the rates of persistence (0.2% MIP vs 0% OP, P = .61) or recurrence (2.5% MIP vs 1.9% OP, P = .68) between the 2 groups. The Kaplan-Meier estimates did, however, began to separate beyond 8 years' follow-up. The OP group did experience a greater incidence of transient hypocalcemia postoperatively (1.9% vs 0.1%, P = .01). CONCLUSION:MIP appears equivalent to OP in single-gland disease. Although patients undergoing OP experienced more transient hypocalcemia, patients undergoing MIP appear to have a greater long-term recurrence rate. Therefore, proper patient selection and counseling of these risks is necessary for either approach.
Authors: William B Inabnet; Gregory F Dakin; Richard S Haber; Francesco Rubino; Ed J Diamond; Michel Gagner Journal: World J Surg Date: 2002-05-21 Impact factor: 3.352
Authors: Allan Siperstein; Eren Berber; Richard Mackey; Mohammed Alghoul; Kristin Wagner; Mira Milas Journal: Surgery Date: 2004-10 Impact factor: 3.982
Authors: Mehmet Haciyanli; Geeta Lal; Eugene Morita; Quan-Yang Duh; Electron Kebebew; Orlo H Clark Journal: J Am Coll Surg Date: 2003-11 Impact factor: 6.113
Authors: Jocelyn F Burke; Kalpana Naraharisetty; David F Schneider; Rebecca S Sippel; Herbert Chen Journal: Am J Surg Date: 2013-01-22 Impact factor: 2.565
Authors: Kirby Tobin; Rachel R Ayers; Mohammad Rajaei; Rebecca S Sippel; Courtney J Balentine; Dawn Elfenbein; Herb Chen; David F Schneider Journal: Int J Endocr Oncol Date: 2016-02
Authors: Naykky M Singh Ospina; Rene Rodriguez-Gutierrez; Spyridoula Maraka; Ana E Espinosa de Ycaza; Sina Jasim; Ana Castaneda-Guarderas; Michael R Gionfriddo; Alaa Al Nofal; Juan P Brito; Patricia Erwin; Melanie Richards; Robert Wermers; Victor M Montori Journal: World J Surg Date: 2016-10 Impact factor: 3.352