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World Journal of Surgery

, Volume 32, Issue 2, pp 224–231 | Cite as

Thoracoscopic Removal of Mediastinal Hyperfunctioning Parathyroid Glands: Personal Experience and Review of the Literature

  • P. F. AlesinaEmail author
  • D. Moka
  • J. Mahlstedt
  • M. K. Walz
Article

Abstract

Background

The presence of a mediastinal hyperfunctioning parathyroid gland is a rare condition that occurs in about 1% to 2% of cases. We present our experience with video-endoscopic parathyroidectomy and a review of the literature.

Methods

In seven patients (four male, three female; age 28–67 years) mediastinal hyperfunctioning parathyroid glands were removed by the thoracoscopic route (VATS). Six patients suffered from primary hyperpathyroidism and one woman from recurrent secondary hyperparathyroidism. Additionally, articles concerning endoscopic treatment of mediastinal parathyroid glands were collected from the medical databases. A total of 58 patients were found in the English and French literature.

Results

Neither intraoperative nor postoperative complications occurred in our patients. Operating time was 90 minutes (range 40–180 minutes). After a mean follow-up of 29 ± 12 months (range 3–64), all patients are biochemically cured. The cases in the literature showed healing in 57 of 58 cases. Their mean operating time was 112 minutes (range 40–240 minutes). One perioperative death due to myocardial infarction and a major complications rate of 7% are described.

Conclusion

The thoracoscopic approach to mediastinal parathyroidectomy is a safe, feasible technique with a low complication rate and good cosmetic outcome. It should become the standard surgical access for mediastinal hyperfunctioning parathyroid glands.

Keywords

Parathyroid Gland Primary Hyperparathyroidism Parathyroid Adenoma Median Sternotomy Parathyroid Tissue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • P. F. Alesina
    • 1
    Email author
  • D. Moka
    • 2
  • J. Mahlstedt
    • 2
  • M. K. Walz
    • 1
  1. 1.Clinic of Surgery and Centre of Minimally Invasive SurgeryKliniken Essen-Mitte, Evang. Huyssens-Stiftung, Akademisches Lehrkrankenhaus der Universität Duisburg-EssenEssenGermany
  2. 2.Institute for Radiology and Nuclear MedicineEssenGermany

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