Factors affecting the development of the parathyroid surgery
Mustafa Çaycı2, Ömer Karahan1, Mehmet Ali Eryılmaz1, Barış Sevinç1, Kemal Arslan1, Ahmet Okuş1, Cevdet Duran3
1Konya Eğitim ve Araştırma Hastanesi, Genel Cerrahi, Konya, Türkiye
2Konya Eğitim ve Araştırma Hastanesi, Nükleer Tıp, Konya, Türkiye
3Konya Eğitim ve Araştırma Hastanesi, Endokrinoloji, Konya, Türkiye
Abstract
Aim: The purpose of this study is to determine the factors affecting the development of parathyroid surgery in our hospital.
Material and Method: We investigated the age, sex, laboratory, imaging and histopathologic data about the patients who had undergone parathyroid surgery between 2000 and 2010. We evaluated the methods used in diagnosis, determination of surgical indications, surgical and anesthesia techniques and the follow up period. We determined the data that can play a role in the process of diagnosis and treatment of this disease.
Results: Until 2005 there were important deficiencies about laboratory investigations and specialists for parathyroid surgery. These were resolved in 2006, except an experienced surgeon. There had been only 2 parathyroid operations until February 2010 (one in 2002 and the other in 2007). In 2008 there was a case with incidental parathyroid adenoma excision during a thyroidectomy. In 2009, with the inauguration of an experienced surgeon, the parathyroid surgeries gained momentum. After this date, there were 28 parathyroid surgeries in 22 months. Twenty two of the cases had primary hiperparathyroidism and 6 had secondary hiperparathyroidism. Twenty one (95,5%) of the 22 parathyroid adenomas underwent MIP. Six patients with secondary hyperparathyroidism underwent total parathyroidectomy and parathyroid autotransplantation. The success rate of the treatment was 100%.
Conclusion: Parathyroid surgery is a team work. With an appropriate team, more than 90% of parathyroid adenomas can be treated by MIP.
Keywords: parathyroidectomy, minimal invasive, infiltration anesthesia, surgical experience