Minimally invasive video-assisted parathyroidectomy (MIVAP) without intraoperative PTH determination

Casanueva, Rodrigo; López, Fernando; Coca‐Pelaz, Andrés; Llorente, José Luís; Rodrigo, Juan P.

doi:10.1007/s00405-021-06740-6

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Minimally invasive parathyroidectomy is a well‐established and standard approach in humans for treatment of PHPT 14–16,24 . The cause of PHPT in 85% of cases was a single adenoma, making minimally invasive surgery an approach with high success rates with appropriate case selection 14–16,24,26 . Published contraindications for a minimally invasive approach include equivocal imaging studies, suspected multiglandular disease, and patients with known risk of multiglandular disease 14,15 .…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16]24 The cause of PHPT in 85% of cases was a single adenoma, making minimally invasive surgery an approach with high success rates with appropriate case selection. [14][15][16]24,26 Published contraindications for a minimally invasive approach include equivocal imaging studies, suspected multiglandular disease, and patients with known risk of multiglandular disease. 14,15 The percentage of single gland disease has been reported between 60%-85% in dogs.…”

Section: Discussionmentioning

confidence: 99%

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Surgical description and outcome of ultrasound‐guided minimally invasive parathyroidectomy in 50 dogs with primary hyperparathyroidism

Young

Degner

2022

Veterinary Surgery

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To describe the surgical technique and clinical outcome of minimally invasive parathyroidectomy for primary hyperparathyroidism (PHPT) in the dog.Animals: Fifty client-owned dogs with PHPT that underwent minimally invasive parathyroidectomy. Study design: Retrospective cohort study.Methods: An ultrasound-guided mini lateral approach was made via a plane established between the sternocephalicus muscle and sternohyoideus muscles to expose the thyroid gland and enlarged parathyroid gland. Abnormal parathyroid glands were removed en bloc via partial thyroidectomy. The technique for bilateral disease was similar, the skin incision was made on midline and moved laterally to develop the above-mentioned plane of dissection. Age, sex, breed, bodyweight, ultrasound findings, histopathological diagnosis, surgical time, preoperative clinical signs, and clinical outcome were extracted from the records for descriptive statistics.Results: A total of 62 glands were surgically removed, including 17 hyperplastic glands (17/62, 27.4%), 34 adenomas (34/62, 54.8%), and two carcinomas (2/62, 3.2%). Hypercalcemia resolved shortly after surgery in 44 dogs (44/45, 97.8%). One dog had recurrent hypercalcemia (1/45, 2.2%), one dog had persistent hypercalcemia (1/45, 2.2%), two dogs had permanent hypocalcemia requiring life-long calcitriol supplementation (2/45, 4.4%), and one dog died from clinical hypocalcemia (1/45, 2.2%). Conclusion:Minimally invasive parathyroidectomy was associated with a low morbidity and led to favorable outcomes in 44/45 dogs in this series. Clinical significance: The results of this study supports the use of minimally invasive parathyroidectomy to treat PHPT in dogs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical description and outcome of ultrasound‐guided minimally invasive parathyroidectomy in 50 dogs with primary hyperparathyroidism

Young

Degner

2022

Veterinary Surgery

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“…MIVAP swiftly gained acceptance as the standard approach to parathyroidectomy. Notably, it offered distinct advantages over BNE, primarily in terms of improved cosmetic outcomes [ 4 , 5 ]. Comparative studies between traditional parathyroidectomy and MIVAP have also highlighted advantages, such as significantly reduced operation time (mean 29.0+/-7.9 minutes versus 69.4+/-26.5 minutes) and lower postoperative pain scores (1.4+/-0.4 versus 2.6+/-0.6 at one hour) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Open Minimally Invasive Parathyroidectomy Versus Minimally Invasive Video-Assisted Parathyroidectomy: A Systematic Review and Meta-Analysis

Saleki,

Master,

Noor

et al. 2023

Cureus

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Various minimally invasive techniques exist for surgical parathyroidectomy. The aim of this study was to conduct a meta-analysis comparing two popular minimally invasive techniques: minimally invasive video-assisted parathyroidectomy (MIVAP) and open minimally invasive parathyroidectomy (OMIP). An extensive search was conducted of online databases to identify all previous studies that had compared MIVAP and OMIP. The primary outcome measures considered were visual analog scale (VAS) score 24 hours postoperatively, conversion of operation (to open), failure rate and analgesic consumption. The data from these studies was extracted and compiled into a meta-analysis. The literature search yielded 104 studies of which four were included, enrolling 903 patients in this analysis. A significant difference was found regarding rates of conversion to open parathyroidectomy between the two groups, with the OMIP group demonstrating fewer conversions (MD = 3.52, CI = (2.04-6.08), P< 0.00001). No statistically significant differences were found between the two groups when comparing postoperative VAS scores at 24 hours (MD = -1.75, CI = (-9.8-6.3), P = 0.67), consumption of analgesia (OR = 0.49, CI = 0.07-3.54, P = 0.48) or failure rates (OR = 1.81, CI = 0.58-5.72, P = 0.31). OMIP was seen to require less need to convert to open parathyroidectomy with shorter operative times, while similar complication rates and scar lengths to MIVAP. More studies are required to evaluate the superior technique for parathyroidectomy.

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“…Preoperative localization of adenomas and the availability of intraoperative PTH monitoring have enabled focused parathyroidectomy in many institutions. In particular, minimally invasive video-assisted parathyroid surgery reduces the extent of surgery, discomfort, recovery time, and leads to a high cure rate 5–7 . A correct localization of adenoma(s), even if it was only the correct sidedness in nonectopic adenomas, is essential for focused parathyroidectomy.…”

mentioning

confidence: 99%

Histopathological Features of Parathyroid Adenoma and 18F-Choline Uptake in PET/MR of Primary Hyperparathyroidism

Liberini

Morand²,

Rupp

et al. 2022

Clin Nucl Med

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Background The aim of this study was to assess the relationship between the histopathological properties of hyperfunctioning parathyroids and parathyroid 18F-choline uptake. Patients and Methods A total of 31 parathyroid adenomas were retrospectively analyzed in patients with primary hyperparathyroidism and preoperative 18F-choline PET/MR. PET/MR parameters of parathyroid glands (SUVmax and target-to-background ratio in early-phase [EP] and late-phase [LP]), MRI volume, preoperative parathyroid hormone (PTH) serum concentration, and postoperative histopathology (predominant cell type and growth pattern of adenoma cells, location and size of adenoma) were assessed. The relationship of PET/MR parameters, PTH, and histological parameters was determined using linear regression, Spearman correlation and Kruskal-Wallis test. Results The median volume of parathyroid adenoma was 421.78 ± 142.46 mm3 (46.39–4412.69). Adenomas were predominantly composed of chief, water-clear, and oncocytic/oxyphilic cells in 27/31, 2/31, and 2/31 cases, respectively. The growth pattern was predominantly solid, follicular, and trabecular in 18/31, 8/31, and 5/31, respectively. The SUVmax was 6.71 ± 3.39 in EP and 6.91 ± 3.97 in LP. Follicular growth pattern had slightly higher EP SUVmax (trabecular: 4.12 ± 0.56; solid: 6.62 ± 3.19; follicular: 8.56 ± 3.96; P = 0.046). Spearman correlation showed strong positive correlation between volume and both EP and LP SUVmax (0.626; P = 0.0001 and 0.576; P = 0.0001, respectively). Linear regression analysis revealed significant correlation between PTH level and EP and LP SUVmax (both P = 0.001); in contrast, no correlation was found between PTH level and both cell type and growth pattern. Conclusions Our findings suggest that 18F-choline uptake of parathyroid adenomas might be associated both with the histological growth pattern and adenoma volume, but not with a specific cell type.

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Minimally invasive video-assisted parathyroidectomy (MIVAP) without intraoperative PTH determination

Cited by 3 publications

References 23 publications

Surgical description and outcome of ultrasound‐guided minimally invasive parathyroidectomy in 50 dogs with primary hyperparathyroidism

Surgical description and outcome of ultrasound‐guided minimally invasive parathyroidectomy in 50 dogs with primary hyperparathyroidism

Open Minimally Invasive Parathyroidectomy Versus Minimally Invasive Video-Assisted Parathyroidectomy: A Systematic Review and Meta-Analysis

Histopathological Features of Parathyroid Adenoma and 18F-Choline Uptake in PET/MR of Primary Hyperparathyroidism

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