Ambulatory bilateral neck exploration for primary hyperparathyroidism: is it safe?

作者：Kiernan Colleen M^*; Schlegel Cameron; Isom Chelsea; Kavalukas Sandra; Peters Mary F; Solorzano Carmen C

来源：American Journal of Surgery, 2016, 212(4): 722-727.

DOI：10.1016/j.amjsurg.2016.06.021

• Outpatient
• Ambulatory
• Parathyroidectomy
• Bilateral exploration
• Focused parathyroidectomy
• Complications

BACKGROUND: We sought to determine if bilateral neck exploration (BNE) for hyperparathyroidism could be performed safely in an ambulatory setting (same-day discharge) when compared with focused parathyroidectomy.
METHODS: A retrospective review of 503 patients who underwent parathyroidectomy from 2010 to 2015 was performed. Focused parathyroidectomy was compared with BNE. Only patients with positive localization and no prior operations were included.
RESULTS: Forty-nine percent of patients underwent focused parathyroidectomy and 51% had BNE. BNE patients were more likely to have 1 or more glands removed (35% vs 14%, P < .01) and longer operative times (median 50 vs 41 minutes, P < .01). There were no differences in the rate of same-day discharge, transient hypocalcemia, emergency department visits, and readmissions.
CONCLUSIONS: In this study, BNE for hyperparathyroidism was associated with excision of more parathyroid glands and slightly longer operative times. However, BNE had equal rates of same-day discharges and safety profile.

• 出版日期2016-10