Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy

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Objective. Show our experience performing the minimally invasive video-assisted parathyroidectomy with central approach for the treatment of patients with primary hyperparathyroidism without using intraoperative parathyroid hormone monitoring (IPTHM) based solely on the concordance of two preoperati...

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Autores principales: Gramática, Luis, Cecenarro, Rodolfo Raúl, Antueno, Facundo Jorge, Villablanca, Noelia Susana
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2017
Materias:
parathyroidectomy
MIVAP
MIBI
primary hyperparathyroidism
ultrasound.
paratiroidectomía
hiperparatiroidismo primario
ecografía
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/15594
Aporte de:
Revistas de la UNC de Universidad Nacional de Córdoba
id I10-R10-article-15594
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-10
container_title_str Revistas de la UNC
language Español
format Artículo revista
topic parathyroidectomy
MIVAP
MIBI
primary hyperparathyroidism
ultrasound.
paratiroidectomía
hiperparatiroidismo primario
ecografía
spellingShingle parathyroidectomy
MIVAP
MIBI
primary hyperparathyroidism
ultrasound.
paratiroidectomía
hiperparatiroidismo primario
ecografía
Gramática, Luis
Cecenarro, Rodolfo Raúl
Antueno, Facundo Jorge
Villablanca, Noelia Susana
Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy
topic_facet parathyroidectomy
MIVAP
MIBI
primary hyperparathyroidism
ultrasound.
paratiroidectomía
hiperparatiroidismo primario
ecografía
author Gramática, Luis
Cecenarro, Rodolfo Raúl
Antueno, Facundo Jorge
Villablanca, Noelia Susana
author_facet Gramática, Luis
Cecenarro, Rodolfo Raúl
Antueno, Facundo Jorge
Villablanca, Noelia Susana
author_sort Gramática, Luis
title Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy
title_short Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy
title_full Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy
title_fullStr Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy
title_full_unstemmed Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy
title_sort primary hyperthyroidism. minimally invasive video-assisted parathyroidectomy
description Objective. Show our experience performing the minimally invasive video-assisted parathyroidectomy with central approach for the treatment of patients with primary hyperparathyroidism without using intraoperative parathyroid hormone monitoring (IPTHM) based solely on the concordance of two preoperative localization studies.Material and methods. An informed consent for the accomplishment of a minimally invasive approach was performed on 27 selected patients diagnosed with primary hyperparathyroidism who underwent pre-operative cervical ultrasound and sesta-MIBI scintigraphy studies, which were consistent across them. None had a family history that might indicate a multiple endocrine neoplasia (MEN), known thyroid disease, previous neck incision, or suspicion of carcinoma. Surgery was performed through a 1.5 cm central cervical incision and the use of harmonic scalpel. IPTHM was not performed in either case.Results. In all cases the topographic location of the adenoma was confirmed. No signs of hyperparathyroidism persistence or recurrence were registered after a follow-up period of 42 months. There were no recurrent nerve lesions. The average operative time was 24.5 minutes and all patients were discharged within 24 hours. The analgesic requirement was minimal and the cosmetic result satisfactory.Conclusion: The minimally invasive unilateral exploration of the parathyroids with video-assisted magnification without IPTHM, under the guidance of two concordant localization studies is safe and feasible, with comparable results to those of standard technique as well as aesthetic advantages, less postoperative pain and reduced hospitalization.
publisher Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2017
url https://revistas.unc.edu.ar/index.php/med/article/view/15594
work_keys_str_mv AT gramaticaluis primaryhyperthyroidismminimallyinvasivevideoassistedparathyroidectomy
AT cecenarrorodolforaul primaryhyperthyroidismminimallyinvasivevideoassistedparathyroidectomy
AT antuenofacundojorge primaryhyperthyroidismminimallyinvasivevideoassistedparathyroidectomy
AT villablancanoeliasusana primaryhyperthyroidismminimallyinvasivevideoassistedparathyroidectomy
AT gramaticaluis hiperparatiroidismoprimarioparatiroidectomiaminiinvasivavideoasistida
AT cecenarrorodolforaul hiperparatiroidismoprimarioparatiroidectomiaminiinvasivavideoasistida
AT antuenofacundojorge hiperparatiroidismoprimarioparatiroidectomiaminiinvasivavideoasistida
AT villablancanoeliasusana hiperparatiroidismoprimarioparatiroidectomiaminiinvasivavideoasistida
first_indexed 2022-08-20T01:24:47Z
last_indexed 2022-08-20T01:24:47Z
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spelling I10-R10-article-155942019-05-20T10:37:29Z Primary Hyperthyroidism. Minimally invasive video-assisted parathyroidectomy Hiperparatiroidismo primario. Paratiroidectomia miniinvasiva videoasistida Gramática, Luis Cecenarro, Rodolfo Raúl Antueno, Facundo Jorge Villablanca, Noelia Susana parathyroidectomy MIVAP MIBI primary hyperparathyroidism ultrasound. paratiroidectomía hiperparatiroidismo primario ecografía Objective. Show our experience performing the minimally invasive video-assisted parathyroidectomy with central approach for the treatment of patients with primary hyperparathyroidism without using intraoperative parathyroid hormone monitoring (IPTHM) based solely on the concordance of two preoperative localization studies.Material and methods. An informed consent for the accomplishment of a minimally invasive approach was performed on 27 selected patients diagnosed with primary hyperparathyroidism who underwent pre-operative cervical ultrasound and sesta-MIBI scintigraphy studies, which were consistent across them. None had a family history that might indicate a multiple endocrine neoplasia (MEN), known thyroid disease, previous neck incision, or suspicion of carcinoma. Surgery was performed through a 1.5 cm central cervical incision and the use of harmonic scalpel. IPTHM was not performed in either case.Results. In all cases the topographic location of the adenoma was confirmed. No signs of hyperparathyroidism persistence or recurrence were registered after a follow-up period of 42 months. There were no recurrent nerve lesions. The average operative time was 24.5 minutes and all patients were discharged within 24 hours. The analgesic requirement was minimal and the cosmetic result satisfactory.Conclusion: The minimally invasive unilateral exploration of the parathyroids with video-assisted magnification without IPTHM, under the guidance of two concordant localization studies is safe and feasible, with comparable results to those of standard technique as well as aesthetic advantages, less postoperative pain and reduced hospitalization. ResumenObjetivo. Mostrar nuestra experiencia realizando la paratiroidectomía miniinvasiva video-asistida con abordaje central para el tratamiento de pacientes con hiperparatiroidismo primario, sin utilizar el monitoreo intraoperatorio de paratohormona (mipth), basados únicamente en la concordancia de dos estudios de localización preoperatorios.Material y métodos. Se seleccionaron 27 pacientes con diagnóstico de hiperparatiroidismo primario, a los cuales se les realizó previo su consentimiento para la realización de un abordaje miniinvasivo, una ecografía cervical y una centellografía sesta-MIBI como estudios de localización pre-operatorios, los cuales fueron concordantes en todo ellos. Ninguno presentó antecedentes familiares que hicieran sospechar una neoplasia endócrina múltiple (NEM), enfermedad tiroidea conocida, cervicotomía previa, ni sospecha de carcinoma. La cirugía se realizó a través de una incisión cervical central de 1,5 cm. con el empleo del bisturí harmónico. El mipth no se realizó en ninguno de los casos.Resultados. En todos los casos se confirmó la ubicación topográfica del adenoma. No registramos persistencias del hiperparatiroidismo ni recidivas después de un período de seguimiento de 42 meses. No hubo lesiones recurrenciales. El  tiempo quirúrgico promedio fue de 24,5 minutos y todos los pacientes se fueron de alta antes de las 24 horas. El requerimiento analgésico fue mínimo, y el resultado estético satisfactorio.Conclusión: La exploración unilateral miniinvasiva de las paratiroides con magnificación videoasistida sin mipth, bajo la guía de dos estudios de localización concordantes, es un procedimiento seguro y factible, con resultados comparables a los de la técnica estándar y con ventajas en lo estético, menor dolor postoperatorio y hospitalización reducida. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2017-12-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document https://revistas.unc.edu.ar/index.php/med/article/view/15594 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 74 No. 4 (2017); 361-364 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 74 Núm. 4 (2017); 361-364 Revista da Faculdade de Ciências Médicas de Córdoba; v. 74 n. 4 (2017); 361-364 1853-0605 0014-6722 10.31053/1853.0605.v74.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/15594/19548 https://revistas.unc.edu.ar/index.php/med/article/view/15594/26439 Derechos de autor 2017 Universidad Nacional de Córdoba

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