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Year : 2019  |  Volume : 52  |  Issue : 1  |  Page : 6-10

Minimally invasive removal of mediastinal ectopic parathyroid glands: A single-center experience

Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko, Chang Gung University, Taoyuan, Taiwan

Correspondence Address:
Dr. Yin-Kai Chao
Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko, Taoyuan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_33_18

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Background: The last few years have seen the emergence of minimally invasive mediastinal parathyroidectomy. Here, we report our single-center experience with this procedure. Materials and Methods: Between December 2002 and September 2017, we performed minimally invasive mediastinal parathyroidectomy in 12 patients with primary (n = 4) or secondary (n = 8) hyperparathyroidism (median age: 54.5 years; interquartile range: 50.5 − 62.75 years). The following variables were retrospectively collected from clinical records: demographic characteristics, results of imaging studies, surgical approach, complications, and final pathological diagnosis. Results: Technetium-99 m sestamibi examinations were performed for preoperative localization of the ectopic parathyroid glands in 11 patients (91.67%). All cases successfully underwent minimally invasive mediastinal parathyroidectomy, without the necessity to convert to open surgery. The most commonly used minimally invasive approach was video-assisted thoracoscopic surgery (n = 10; 83.33%) followed by mediastinoscopy (n = 2; 16.67%). The anatomical locations of the ectopic glands were as follows: intrathymic in six patients (50%), within the aortopulmonary window in 1 patient (8%), and in other intrathoracic sites in five patients (42%). Parathyroid adenomas and parathyroid hyperplasias were diagnosed in 5 (42%) and seven patients (58%), respectively. There were no perioperative deaths, and the median length of hospital stay was 5.5 days. Conclusion: Minimally invasive removal of mediastinal ectopic parathyroid glands is safe and feasible if their anatomical position is accurately determined. Surgical approaches depend on gland location and the surgeon's preference.

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