Objective: To retrospectively evaluate the feasibility of thoracoscopic removal of mediastinal parathyroids. SUMMARY BACKGROUND DATA Mediastinal exploration to resect ectopic parathyroid(s) is needed in approximately 2% of cases in hyperparathyroidism. Recent advances in thoracoscopic surgery allow for a minimally invasive treatment. Methods: From 1999 through 2007, 13 patients affected by primary hyperparathyroidism (11 females, mean age 60 years, range: 22-88) underwent thoracoscopic removal of mediastinal parathyroids. Scintigraphy produced positive Results: in 11 of 13 cases, computed tomography scan in 9 of 10, parathyroid hormone venous sampling in 10 of 10 patients, and magnetic resonance imaging in 5 of 7. Right thoracoscopic access was used in 9 patients, left in 4. Postoperative outcome was analyzed. Results: Thoracoscopy enabled retrieval of mediastinal parathyroids in 10 of 13 (78%) cases. Mean operating time was 92 minutes (range: 50-240). One procedure (8%) was converted. No perioperative deaths/major complications occurred. Mild complications occurred in 2 of 13 (15%) patients (pneumothorax/pneumonia, transient recurrent nerve palsy). Mean hospital stay was 4.7 days (range: 2-15). At a mean follow-up of 73 months (range: 16-105), parathyroid hormone and calcium venous concentrations were high in 3 patients. Unsuccessful procedures were related to doubtful or non-concordant preoperative localization. Conclusion:S The thoracoscopic approach for mediastinal parathyroidectomy is feasible and safe. An accurate preoperative work-up should be standardized to avoid useless procedures. In case of negative preoperative localization of the abnormal gland, thoracoscopy should not be adopted as a diagnostic tool

THORACOSCOPIC REMOVAL OF MEDIASTINAL PARATHYROID GLANDS. A CRITICAL APPRAISAL OF AN EMERGING TECHNIQUE / Randone, B; Costi, Renato; Scatton, O; Fulla, Y; Bertagna, X; Soubrane, O; Bonnichon, P. h.. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 251:(2010), pp. 717-721. [10.1097/sla.0b013e3181c1cfb0]

THORACOSCOPIC REMOVAL OF MEDIASTINAL PARATHYROID GLANDS. A CRITICAL APPRAISAL OF AN EMERGING TECHNIQUE.

COSTI, Renato;
2010-01-01

Abstract

Objective: To retrospectively evaluate the feasibility of thoracoscopic removal of mediastinal parathyroids. SUMMARY BACKGROUND DATA Mediastinal exploration to resect ectopic parathyroid(s) is needed in approximately 2% of cases in hyperparathyroidism. Recent advances in thoracoscopic surgery allow for a minimally invasive treatment. Methods: From 1999 through 2007, 13 patients affected by primary hyperparathyroidism (11 females, mean age 60 years, range: 22-88) underwent thoracoscopic removal of mediastinal parathyroids. Scintigraphy produced positive Results: in 11 of 13 cases, computed tomography scan in 9 of 10, parathyroid hormone venous sampling in 10 of 10 patients, and magnetic resonance imaging in 5 of 7. Right thoracoscopic access was used in 9 patients, left in 4. Postoperative outcome was analyzed. Results: Thoracoscopy enabled retrieval of mediastinal parathyroids in 10 of 13 (78%) cases. Mean operating time was 92 minutes (range: 50-240). One procedure (8%) was converted. No perioperative deaths/major complications occurred. Mild complications occurred in 2 of 13 (15%) patients (pneumothorax/pneumonia, transient recurrent nerve palsy). Mean hospital stay was 4.7 days (range: 2-15). At a mean follow-up of 73 months (range: 16-105), parathyroid hormone and calcium venous concentrations were high in 3 patients. Unsuccessful procedures were related to doubtful or non-concordant preoperative localization. Conclusion:S The thoracoscopic approach for mediastinal parathyroidectomy is feasible and safe. An accurate preoperative work-up should be standardized to avoid useless procedures. In case of negative preoperative localization of the abnormal gland, thoracoscopy should not be adopted as a diagnostic tool
2010
THORACOSCOPIC REMOVAL OF MEDIASTINAL PARATHYROID GLANDS. A CRITICAL APPRAISAL OF AN EMERGING TECHNIQUE / Randone, B; Costi, Renato; Scatton, O; Fulla, Y; Bertagna, X; Soubrane, O; Bonnichon, P. h.. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 251:(2010), pp. 717-721. [10.1097/sla.0b013e3181c1cfb0]
File in questo prodotto:
File Dimensione Formato  
Costi_Renato_lavoro_ N.1.pdf

non disponibili

Tipologia: Altro materiale allegato
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 423.7 kB
Formato Adobe PDF
423.7 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2319783
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 31
  • ???jsp.display-item.citation.isi??? 31
social impact