Abstract

INTRODUCTION

Our purpose was to evaluate and compare the results of minimally invasive parathyroidectomy (MIP) with intraoperative parathormone (IOPTH) monitoring and conventional bilateral neck exploration (BNE) without IOPTH monitoring in patients with primary hyperparathyroidism (pHPT) in a follow-up period of observation.

METHODS

Of the 68 patients in the study, 33 patients (48.5 %) underwent MIP with IOPTH monitoring, 35 patients (51.5 %) underwent bilateral neck exploration without IOPTH monitoring. Data regarding imaging, localization site, surgery performed, incision size, operative time, adenoma size, postoperative complication, and calcium/PTH measurements obtained at postoperative 6th and 12th months were collected from the patient charts.

RESULTS

A statistically significant difference was not seen between MIP, and BNE groups as for the amount of changes in PTH blood levels according to these two time-points of the follow-up period (p>0.05). When compared with MIP group, in BNE group, blood Ca levels increased to a greater extent also at postoperative 12. month relative to postoperative 6. month (p=0.005). As for the comparison of the groups with successful, and failed outcomes, negative effects of male gender, and possession of at least one comorbidity on success rates were detected (p=0.007, and p=0.002). Statistically significant effects of type of surgery, and median size of the adenoma on success rates were not seen (p=0.314, and p=0.615).

DISCUSSION AND CONCLUSION

Minimally invasive parathyroidectomy performed with IOPTH analysis, and parathyroidectomy using BNE method have similar, and acceptable success rates.