Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma
Background Primary hyperparathyroidism (PHPT), caused by an ectopic mediastinal parathyroid adenoma, is uncommon. In the past, when the adenoma was not accessible from the neck, median sternotomy was advocated for safe and successful parathyroidectomy. Video‐assisted thoracoscopic surgical (VATS) pa...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Oxford University Press
2019-12-01
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| Series: | BJS Open |
| Online Access: | https://doi.org/10.1002/bjs5.50207 |
| _version_ | 1829134083865706496 |
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| author | K. E. Isaacs S. Belete B. J. Miller A. N. Di Marco S. Kirby T. Barwick N. S. Tolley J. R. Anderson F. F. Palazzo |
| author_facet | K. E. Isaacs S. Belete B. J. Miller A. N. Di Marco S. Kirby T. Barwick N. S. Tolley J. R. Anderson F. F. Palazzo |
| author_sort | K. E. Isaacs |
| collection | DOAJ |
| description | Background Primary hyperparathyroidism (PHPT), caused by an ectopic mediastinal parathyroid adenoma, is uncommon. In the past, when the adenoma was not accessible from the neck, median sternotomy was advocated for safe and successful parathyroidectomy. Video‐assisted thoracoscopic surgical (VATS) parathyroidectomy represents a modern alternative approach to this problem. Methods Information on patients undergoing VATS was obtained from a specific database, including clinical presentation, biochemistry, preoperative imaging, surgical approach and patient outcomes. A comprehensive literature review was undertaken to draw comparisons with other publications. Results Over a 2‐year period, nine patients underwent VATS parathyroidectomy for sporadic PHPT. Five patients had persistent PHPT following previous unsuccessful parathyroidectomy via cervicotomy, and four had had no previous parathyroid surgery. The median duration of surgery was 90 (range 60–160) min. Eight patients were cured biochemically, with no major complications. One patient required conversion to a median sternotomy for removal of a thymoma that had resulted in false‐positive preoperative imaging. Conclusion With appropriate preoperative imaging, multidisciplinary input and expertise, VATS parathyroidectomy is an effective, safe and well tolerated approach to ectopic mediastinal parathyroid adenoma. |
| first_indexed | 2024-12-14T17:54:11Z |
| format | Article |
| id | doaj.art-2115c421b8974217938807e42dcb7257 |
| institution | Directory Open Access Journal |
| issn | 2474-9842 |
| language | English |
| last_indexed | 2024-12-14T17:54:11Z |
| publishDate | 2019-12-01 |
| publisher | Oxford University Press |
| record_format | Article |
| series | BJS Open |
| spelling | doaj.art-2115c421b8974217938807e42dcb72572022-12-21T22:52:35ZengOxford University PressBJS Open2474-98422019-12-013674374910.1002/bjs5.50207Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenomaK. E. Isaacs0S. Belete1B. J. Miller2A. N. Di Marco3S. Kirby4T. Barwick5N. S. Tolley6J. R. Anderson7F. F. Palazzo8Department of Endocrine Surgery Imperial College Healthcare NHS Trust London UKDepartment of Endocrine Surgery Imperial College Healthcare NHS Trust London UKDepartment of Endocrine Surgery Imperial College Healthcare NHS Trust London UKDepartment of Endocrine Surgery Imperial College Healthcare NHS Trust London UKDepartment of Radiology Imperial College Healthcare NHS Trust London UKDepartment of Anaesthesia Imperial College Healthcare NHS Trust London UKDepartment of Endocrine Surgery Imperial College Healthcare NHS Trust London UKDepartment of Cardiothoracic Surgery, Hammersmith Hospital Imperial College Healthcare NHS Trust London UKDepartment of Endocrine Surgery Imperial College Healthcare NHS Trust London UKBackground Primary hyperparathyroidism (PHPT), caused by an ectopic mediastinal parathyroid adenoma, is uncommon. In the past, when the adenoma was not accessible from the neck, median sternotomy was advocated for safe and successful parathyroidectomy. Video‐assisted thoracoscopic surgical (VATS) parathyroidectomy represents a modern alternative approach to this problem. Methods Information on patients undergoing VATS was obtained from a specific database, including clinical presentation, biochemistry, preoperative imaging, surgical approach and patient outcomes. A comprehensive literature review was undertaken to draw comparisons with other publications. Results Over a 2‐year period, nine patients underwent VATS parathyroidectomy for sporadic PHPT. Five patients had persistent PHPT following previous unsuccessful parathyroidectomy via cervicotomy, and four had had no previous parathyroid surgery. The median duration of surgery was 90 (range 60–160) min. Eight patients were cured biochemically, with no major complications. One patient required conversion to a median sternotomy for removal of a thymoma that had resulted in false‐positive preoperative imaging. Conclusion With appropriate preoperative imaging, multidisciplinary input and expertise, VATS parathyroidectomy is an effective, safe and well tolerated approach to ectopic mediastinal parathyroid adenoma.https://doi.org/10.1002/bjs5.50207 |
| spellingShingle | K. E. Isaacs S. Belete B. J. Miller A. N. Di Marco S. Kirby T. Barwick N. S. Tolley J. R. Anderson F. F. Palazzo Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma BJS Open |
| title | Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma |
| title_full | Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma |
| title_fullStr | Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma |
| title_full_unstemmed | Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma |
| title_short | Video‐assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma |
| title_sort | video assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenoma |
| url | https://doi.org/10.1002/bjs5.50207 |
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