| Abstract: | Introduction: Minimal invasive parathyroidectomy (MIP) has evolved as a popular method in the treatment of primary hyperparathyroidism. Our study aimed to examine how effective is MIP compared to conventional parathyroidectomy. Methods: All patients with primary hyperparathyroidism received a triage ultrasound scan. In patients who had their parathyroid glands localized by the ultrasound, parathyroidectomy was performed under local anaesthesia (LA‐MIP) via a 3‐cm incision using the lateral approach. In patients with negative imaging, they underwent conventional parathyroidectomy under general anaesthesia (GA). Cure is defined as remaining normocalcemic on follow up. The cure rate, complication rate, hospital stay and number of frozen sections utilized were compared. Results: Forty‐four patients were treated by LA‐MIP and 37 patients were treated by GA since 1999–2003. The positive predictive value of USG localization was 97%. After a median follow up of 24 months, there were no difference in the cure rate (41/44 in LA‐MIP versus 35/37 in GA, P > 0.05) and complication rate (2/44 in LA‐MIP vs 2/37 in GA, P > 0.05). However, the LA group was found to have shorter hosptial stay (median = 1 vs 2 in GA, P < 0.05) and utilized less frozen‐sections (median = 1 vs 2 in GA, P < 0.05). Conclusions: Ultrasound‐guided minimal invasive parathyroidectomy under local anaesthesia is as effective as conventional parathyroidectomy in the treatment of primary hyperparathyroidism. An estimated cost‐reduction of HK $14 432 was found in each case treated by LA‐MIP through utilizing less frozen‐sections, less general anaesthesia and shorter hosiptal stay. |
