Robot-Assisted Thoracoscopic Mediastinal Parathyroidectomy: A Single Surgeon Case Series.
J Laparoendosc Adv Surg Tech A
; 29(12): 1561-1564, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31188050
ABSTRACT
Objective:
Minimally invasive (video-assisted thoracoscopic surgery) mediastinal parathyroidectomy has been described as a technique for surgical management of primary hyperparathyroidism due to ectopic parathyroid adenoma. Herein, we present the largest cohort of patients (n = 8) treated with robot-assisted mediastinal parathyroidectomy and describe our technique for this procedure, pre- and intraoperative variables, and postoperative outcomes. Materials andMethods:
A single surgeon, single institution case series of eight consecutive robot-assisted mediastinal parathyroidectomies performed from April 2013 to March 2018. Preoperative workup, intraoperative variables, and postoperative outcomes were evaluated.Results:
Of the eight patients, seven were women. Average age was 54 years (range 28-69) and average body mass index 33.6 (range 24.8-42.9). Seven patients had a preoperative diagnosis of primary hyperparathyroidism with preoperative parathyroid hormone (PTH) and calcium levels (PTH 137 (70-192); Ca2+ 10.9 (10.2-12), and one patient had preoperative diagnosis of thymoma. Preoperative imaging studies included computed tomography (CT)-sestamibi (n = 3), CT neck (n = 4), CT chest (n = 6), and neck ultrasound (n = 6). Intraoperative PTH measurements found >50% reduction in all cases. Average length of surgery was 108.6 minutes (range 76-186); average blood loss 26 cc. All specimens were parathyroid adenomas, with an average size of 16 mm (range 7-35 mm). Seven of eight patients were discharged on postoperative day 1. No complications or recurrences occurred at a median follow-up of 18.5 days (range 15-1,066 days).Conclusions:
Robot-assisted thoracoscopic parathyroidectomy is a safe and effective technique, with immediate improvement in PTH levels. Thorough clinical, biochemical, and radiologic preoperative workup assists in operative planning and may improve diagnostic accuracy of anterior mediastinal masses.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias das Paratireoides
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Timoma
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Neoplasias do Timo
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Paratireoidectomia
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Cirurgia Torácica Vídeoassistida
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Cirurgia Assistida por Computador
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Mediastino
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Laparoendosc Adv Surg Tech A
Ano de publicação:
2019
Tipo de documento:
Article