Document Detail


Minimally invasive parathyroidectomy using local anesthesia with intravenous sedation and targeted approaches.
MedLine Citation:
PMID:  18312889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Minimally invasive parathyroidectomy (MIP) is generally performed under general anesthesia. This study evaluates the efficacy and safety of MIP performed under intravenous sedation with local anesthesia. STUDY DESIGN: Historical cohort study. SUBJECTS: One hundred eighty-six consecutive patients undergoing MIP using sedation with local anesthesia. METHODS: Two different targeted approaches were used to achieve good exposure with minimal retraction, which allows the procedure to be performed with little discomfort. In all patients, an adenoma was localized preoperatively and its depth mapped by sestamibi scan with single-photon emission computed tomography and/or ultrasound. A midline anterior approach was used for inferior glands that were superficially located. A lateral approach was used for glands that were located posteriorly or superiorly. RESULTS: MIP was successfully completed under local/sedation in 177 patients; 167 were discharged the same day. Complications include two pneumothorax, one small hematoma, and one transient vocal cord paralysis. CONCLUSIONS: By using a targeted approach, MIP can be safely performed under local anesthesia in appropriately selected patients.
Authors:
Maisie L Shindo; Joshua M Rosenthal; Thomas Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  138     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-7     Citation Subset:  IM    
Affiliation:
SUNY at Stony Brook, Stony Brook, NY 11794, USA. maisie.shindo@sunysb.edu
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MeSH Terms
Descriptor/Qualifier:
Adenoma / radionuclide imaging,  surgery*,  ultrasonography
Anesthesia, Local*
Conscious Sedation*
Humans
Parathyroid Neoplasms / radionuclide imaging,  surgery*,  ultrasonography
Parathyroidectomy / methods*
Radiopharmaceuticals / diagnostic use
Surgical Procedures, Minimally Invasive
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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