[Minimally invasive treatment of primary hyperparathyroidism]

Abstract

Background: Parathyroid glands have traditionally been identified by bilateral neck exploration under general anaesthesia in connection with surgical removal of enlarged glands in primary hyperparathyroidism. Unilateral neck exploration can now be done under local anaesthesia without dissecting all glands, due to improved preoperative scintigraphy and measurement of parathyroid hormone (PTH) intra-operatively. This minimally invasive technique was introduced at the University Hospital of Northern Norway in 2004.

Material and methods: Data on patients who had undergone minimally invasive surgery were collected from patient files from 1 January 2004 to 31 December 2006. 41 patients were included in the study.

Results: PTH had normalized for 97% of the patients post-operatively. 7% of the patients had transient hypocalcaemia at discharge. One patient suffered from paralysis of the recurrent laryngeal nerve after surgery. Local anaesthesia had to be converted to general anaesthesia for seven operations (17%).

Interpretation: Preoperative scintigraphy and intra-operative measurements of PTH have made minimally invasive surgery possible. It is currently our preferred treatment in case of unilateral pathology in the parathyroid glands.