최소침습 종양표적하 부갑상선 절제술

Abstract

Purpose: The usual surgical treatment for patients with primary hyperparathyroidism is to remove the diseased parathyroid gland. Despite the high success rate of conventional bilateral exploration of both sides of the neck with identification of all parathyroid glands, there has been considerable recent interest in focal exploration for sporadic primary hyperparathyroidism. The development of preoperative localization methods has been enhancing the effectiveness of various minimally invasive parathyroid surgery. We invented a new surgical method - minimally invasive focused parathyroidecomy (MIFP) and accomplished successful treatment for the patients with primary hyperparathyroidism. The aim of the present paper was to evaluate the effectiveness and safety of this procedure. Methods: From Jan. 2002 through Sep. 2003, 25 consecutive cases out of 39 patients with primary hyperparathyroidism who were treated by MIFP were enrolled in this study. We analysed retrospectively the success rate, operation time, length of incision, hospital stay, complication rate and influence of preoperative localization methods. Results: There were 21 women and 4 men with a mean age of 54.1 years. All were examined preoperatively with ultrasonography and/or 99mTc-sestamibi scan to localize the diseasec parathyroid gland. The mean length of incision was 2.3 cm and mean operation time was 32 min. Twenty-four patients (96.0%) successfully underwent MIFP, with only one case of conversion to conventional approach. Conclusion: MIFP is a safe, cost-effective and definite operative method for patients who are appropriately selected by careful preoperative localization studies.