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MIVAP may be effective alternative for hyperparathyroidism
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SAN JUAN, Puerto Rico — Minimally invasive video-assisted parathyroidectomy, or MIVAP, provided the same cure-effect as conventional bilateral neck exploration, with additional benefits, according to data presented here.
The minimally invasive procedure was associated with lower hypocalcemia, greater cosmetic satisfaction, shorter operative time, less postoperative pain and shorter hospital stay, according to data.
“Primary hyperparathyroidism is a common condition for which parathyroidectomy is curative,” American Thyroid Association program committee co-chair Julie Ann Sosa, MD, of Duke University School of Medicine and Duke Cancer Institute, said in a press release.
Study researcherYouben Fan, PhD, of the Affiliated Sixth People’s Hospital in Shanghai, reported that the group aimed to compare the therapeutic effects of bilateral neck exploration (BNE) and MIVAP.
Patients with primary hyperparathyroidism were randomly assigned to BNE (n=52) or MIVAP (n=56) between April 2005 and July 2011, with a postoperative follow-up at 6 weeks, 6 months and 1 year.
No difference in cure rates was noted between the two groups (95% vs. 96%, P<.005). Researchers discovered that three MIVAP patients and two BNE patients displayed persistent or recurrent hyperparathyroidism. Three patients in the BNE group were converted to the MIVAP group, according to data.
Moreover, patients in the MIVAP group appeared to have a lower incidence of early severe hypocalcemia compared with patients in the BNE group. They also had a higher cosmetic satisfaction rate, shorter operative time, less postoperative pain and shorter hospital stay, according to data.
There were also no differences in mortality, serum calcium and intraoperative parathyroid hormone, according to 6-month follow-up data.
“While bilateral neck exploration has been the traditional approach, minimally invasive parathyroidectomy has emerged as an alternative technique associated with improved patient outcomes, largely based on retrospective, single institution or surgeon clinical series,” Sosa said in the release. “This report is potentially exciting because it represents a randomized controlled trial and specifically looks at minimally invasive, video-assisted parathyroidectomy as compared to traditional open parathyroidectomy.” – by Samantha Costa
For more information:
Fan Y. Poster 147. Presented at: the 83rd Annual Meeting of the American Thyroid Association; Oct. 16-20, 2013; San Juan, Puerto Rico.
Disclosure:Endocrine Today could not confirm financial disclosures at this time.