Minimally invasive resection for mediastinal ectopic parathyroid glands

Sameh M. Said, Stephen D. Cassivi, Mark S. Allen, Claude Deschamps, Francis C. Nichols, K. Robert Shen, Dennis A Wigle

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background We reviewed our experience with ectopic mediastinal parathyroidectomy. Methods Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism. Results Primary hyperparathyroidism was the main diagnosis in 32 patients (97%). Technetium-sestamibi scan was used in 23 (70%) for preoperative localization. Minimally invasive resections were performed in 18 patients (55%), and 15 (45%) underwent open surgery. The most common minimally invasive surgery approach was video-assisted thoracoscopy in 9 patients (27%); the most common open approach was median sternotomy in 11 (33%). Intraoperative parathyroid hormone monitoring was used in 22 patients (67%). The ectopic glands were intrathymic in 15 patients (45%), in the aortopulmonary window in 7 (21%), and in other intrathoracic locations in the remaining 11 (33%). Parathyroid adenomas were identified in 21 patients (64%); parathyroid hyperplasia and carcinoma were identified in 9 (27%) and 3 (9%), respectively. No early mortality occurred in either group. Reoperation was required in 1 patient in the minimally invasive surgery group because of hemothorax. Morbidity occurred in 8 patients (24%), the most common of which was hypocalcemia in 4 (12%). The mean length of stay was significantly shorter in the minimally invasive surgery group (2 versus 6 days; p < 0.001) but mortality and morbidity were not statistically different between the two groups (p = 0.05). Mean follow-up was 3 ± 3.7 years. Conclusions Minimally invasive mediastinal parathyroidectomy has similar outcomes to open surgery, with significantly shorter length of hospital stay.

Original languageEnglish (US)
Pages (from-to)1229-1233
Number of pages5
JournalAnnals of Thoracic Surgery
Volume96
Issue number4
DOIs
StatePublished - Oct 2013

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Parathyroid Glands
Parathyroidectomy
Minimally Invasive Surgical Procedures
Length of Stay
Parathyroid Neoplasms
Morbidity
Hemothorax
Thoracoscopy
Secondary Hyperparathyroidism
Sternotomy
Primary Hyperparathyroidism
Hypocalcemia
Mortality
Technetium
Hypercalcemia
Parathyroid Hormone
Reoperation
Hyperplasia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Said, S. M., Cassivi, S. D., Allen, M. S., Deschamps, C., Nichols, F. C., Shen, K. R., & Wigle, D. A. (2013). Minimally invasive resection for mediastinal ectopic parathyroid glands. Annals of Thoracic Surgery, 96(4), 1229-1233. https://doi.org/10.1016/j.athoracsur.2013.05.084

Minimally invasive resection for mediastinal ectopic parathyroid glands. / Said, Sameh M.; Cassivi, Stephen D.; Allen, Mark S.; Deschamps, Claude; Nichols, Francis C.; Shen, K. Robert; Wigle, Dennis A.

In: Annals of Thoracic Surgery, Vol. 96, No. 4, 10.2013, p. 1229-1233.

Research output: Contribution to journalArticle

Said, SM, Cassivi, SD, Allen, MS, Deschamps, C, Nichols, FC, Shen, KR & Wigle, DA 2013, 'Minimally invasive resection for mediastinal ectopic parathyroid glands', Annals of Thoracic Surgery, vol. 96, no. 4, pp. 1229-1233. https://doi.org/10.1016/j.athoracsur.2013.05.084
Said SM, Cassivi SD, Allen MS, Deschamps C, Nichols FC, Shen KR et al. Minimally invasive resection for mediastinal ectopic parathyroid glands. Annals of Thoracic Surgery. 2013 Oct;96(4):1229-1233. https://doi.org/10.1016/j.athoracsur.2013.05.084
Said, Sameh M. ; Cassivi, Stephen D. ; Allen, Mark S. ; Deschamps, Claude ; Nichols, Francis C. ; Shen, K. Robert ; Wigle, Dennis A. / Minimally invasive resection for mediastinal ectopic parathyroid glands. In: Annals of Thoracic Surgery. 2013 ; Vol. 96, No. 4. pp. 1229-1233.
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abstract = "Background We reviewed our experience with ectopic mediastinal parathyroidectomy. Methods Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism. Results Primary hyperparathyroidism was the main diagnosis in 32 patients (97{\%}). Technetium-sestamibi scan was used in 23 (70{\%}) for preoperative localization. Minimally invasive resections were performed in 18 patients (55{\%}), and 15 (45{\%}) underwent open surgery. The most common minimally invasive surgery approach was video-assisted thoracoscopy in 9 patients (27{\%}); the most common open approach was median sternotomy in 11 (33{\%}). Intraoperative parathyroid hormone monitoring was used in 22 patients (67{\%}). The ectopic glands were intrathymic in 15 patients (45{\%}), in the aortopulmonary window in 7 (21{\%}), and in other intrathoracic locations in the remaining 11 (33{\%}). Parathyroid adenomas were identified in 21 patients (64{\%}); parathyroid hyperplasia and carcinoma were identified in 9 (27{\%}) and 3 (9{\%}), respectively. No early mortality occurred in either group. Reoperation was required in 1 patient in the minimally invasive surgery group because of hemothorax. Morbidity occurred in 8 patients (24{\%}), the most common of which was hypocalcemia in 4 (12{\%}). The mean length of stay was significantly shorter in the minimally invasive surgery group (2 versus 6 days; p < 0.001) but mortality and morbidity were not statistically different between the two groups (p = 0.05). Mean follow-up was 3 ± 3.7 years. Conclusions Minimally invasive mediastinal parathyroidectomy has similar outcomes to open surgery, with significantly shorter length of hospital stay.",
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N2 - Background We reviewed our experience with ectopic mediastinal parathyroidectomy. Methods Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism. Results Primary hyperparathyroidism was the main diagnosis in 32 patients (97%). Technetium-sestamibi scan was used in 23 (70%) for preoperative localization. Minimally invasive resections were performed in 18 patients (55%), and 15 (45%) underwent open surgery. The most common minimally invasive surgery approach was video-assisted thoracoscopy in 9 patients (27%); the most common open approach was median sternotomy in 11 (33%). Intraoperative parathyroid hormone monitoring was used in 22 patients (67%). The ectopic glands were intrathymic in 15 patients (45%), in the aortopulmonary window in 7 (21%), and in other intrathoracic locations in the remaining 11 (33%). Parathyroid adenomas were identified in 21 patients (64%); parathyroid hyperplasia and carcinoma were identified in 9 (27%) and 3 (9%), respectively. No early mortality occurred in either group. Reoperation was required in 1 patient in the minimally invasive surgery group because of hemothorax. Morbidity occurred in 8 patients (24%), the most common of which was hypocalcemia in 4 (12%). The mean length of stay was significantly shorter in the minimally invasive surgery group (2 versus 6 days; p < 0.001) but mortality and morbidity were not statistically different between the two groups (p = 0.05). Mean follow-up was 3 ± 3.7 years. Conclusions Minimally invasive mediastinal parathyroidectomy has similar outcomes to open surgery, with significantly shorter length of hospital stay.

AB - Background We reviewed our experience with ectopic mediastinal parathyroidectomy. Methods Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism. Results Primary hyperparathyroidism was the main diagnosis in 32 patients (97%). Technetium-sestamibi scan was used in 23 (70%) for preoperative localization. Minimally invasive resections were performed in 18 patients (55%), and 15 (45%) underwent open surgery. The most common minimally invasive surgery approach was video-assisted thoracoscopy in 9 patients (27%); the most common open approach was median sternotomy in 11 (33%). Intraoperative parathyroid hormone monitoring was used in 22 patients (67%). The ectopic glands were intrathymic in 15 patients (45%), in the aortopulmonary window in 7 (21%), and in other intrathoracic locations in the remaining 11 (33%). Parathyroid adenomas were identified in 21 patients (64%); parathyroid hyperplasia and carcinoma were identified in 9 (27%) and 3 (9%), respectively. No early mortality occurred in either group. Reoperation was required in 1 patient in the minimally invasive surgery group because of hemothorax. Morbidity occurred in 8 patients (24%), the most common of which was hypocalcemia in 4 (12%). The mean length of stay was significantly shorter in the minimally invasive surgery group (2 versus 6 days; p < 0.001) but mortality and morbidity were not statistically different between the two groups (p = 0.05). Mean follow-up was 3 ± 3.7 years. Conclusions Minimally invasive mediastinal parathyroidectomy has similar outcomes to open surgery, with significantly shorter length of hospital stay.

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