Video-assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenomas

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Title: Video-assisted thoracoscopic surgery for ectopic mediastinal parathyroid adenomas
Authors: Isaacs, K
Belete, S
Miller, B
Di Marco, A
Kirby, S
Barwick, T
Tolley, N
Anderson, J
Palazzo, F
Item Type: Journal Article
Abstract: 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 for this problem. Methods: Information was obtained related to patients undergoing VATS from a specific database, including clinical presentation, biochemistry, pre-operative imaging, surgical approach and patient outcomes. A comprehensive literature review was undertaken to draw comparisons with other publications. Results: Over a 2-year period, 9 patients underwent VATS parathyroidectomy for sporadic pHPT, of whom five had persistent pHPT following previous unsuccessful parathyroidectomy via cervicotomy, while four had had no previous parathyroid surgery. The mean operating time was 101 minutes (range 60 – 160). 8 patients were biochemically cured, with no major complications. 1 patient required conversion to a median sternotomy for removal of a thymoma that had resulted in false positive preoperative imaging. Conclusion: With appropriate pre-operative imaging, multidisciplinary input and expertise, VATS parathyroidectomy is an effective, safe and well-tolerated approach to an ectopic mediastinal parathyroid adenoma.
Issue Date: 19-Aug-2019
Date of Acceptance: 28-May-2019
DOI: 10.1002/bjs5.50207
ISSN: 2474-9842
Publisher: Wiley
Journal / Book Title: BJS Open
Copyright Statement: This paper is embargoed until publication. Once published it will be available fully open access.
Publication Status: Accepted
Embargo Date: publication subject to indefinite embargo
Appears in Collections:Division of Surgery
Department of Medicine
Faculty of Medicine

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