Minimally invasive video-assisted subtotal parathyroidectomy with thymectomy for secondary hyperparathyroidism

Background  Secondary hyperparathyroidism (sHPT) is common in patients with chronic renal failure. Bilateral cervical exploration is optimal for patients with sHPT. The aims of this clinical trial are to evaluate the feasibility of video-assisted subtotal parathyroidectomy as an alternative surgical treatment for sHPT. Methods  This prospective study included 12 consecutive patients with sHPT. Surgical indications included a high intact parathormone level, enlarged parathyroid glands, high bone turnover and conditions refractory to medical treatment of hypercalcemia and hyperphosphatemia. Results  All patients underwent minimally invasive video-assisted subtotal parathyroidectomy and trans-cervical thymectomy. Four cervical glands were found in all patients and intrathymic glands were identified in three (25%) patients. Conclusion  Minimally invasive video-assisted subtotal parathyroidectomy offers an alternative method, and this technique can be performed safely for sHPT.