{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T03:25:53Z","timestamp":1774409153385,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,3,10]],"date-time":"2006-03-10T00:00:00Z","timestamp":1141948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A variety of minimally invasive parathyroidectomy (MIP) techniques have been currently introduced to surgical management of primary hyperparathyroidism (pHPT) caused by a solitary parathyroid adenoma. This study aimed at comparing the video\u2010assisted MIP (MIVAP) and open MIP (OMIP) in a prospective, randomized, blinded trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Among 84 consecutive pHPT patients referred for surgery, 60\u00a0individuals with concordant localization of parathyroid adenoma on ultrasound and subtraction Tc<jats:sup>99m<\/jats:sup>\u2010MIBI scintigraphy were found eligible for MIP under general anesthesia and were randomized to two groups (n = 30 each): MIVAP and OMIP. An intraoperative intact parathyroid hormone (iPTH) assay was routinely used in both groups to determine the cure. Primary end\u2010points were the success rate in achieving the cure from hyperparathyroid state and hypocalcemia rate. Secondary end\u2010points were operating time, scar length, pain intensity assessed by the visual\u2010analogue scale, analgesia request rate, analgesic consumption, quality of life within 7 postoperative days (SF\u201036), cosmetic satisfaction, duration of postoperative hospitalization, and cost\u2010effectiveness analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were cured. In 2 patients, an intraoperative iPTH assay revealed a need for further exploration: in one MIVAP patient, subtotal parathyroidectomy for parathyroid hyperplasia was performed with the video\u2010assisted approach, and in an OMIP patient, the approach was converted to unilateral neck exploration with the final diagnosis of double adenoma. MIVAP versus OMIP patients were characterized by similar operative time (44.2 \u00b1 18.9 vs. 49.7 \u00b1 15.9\u00a0minutes; <jats:italic>P<\/jats:italic> = 0.22), transient hypocalcemia rate (3 vs. 3\u00a0individuals; <jats:italic>P<\/jats:italic> = 1.0), lower pain intensity at 4, 8, 12, and 24 hours after surgery (24.9 \u00b1 6.1 vs. 32.2 \u00b1 4.6; 26.4 \u00b1 4.5 vs. 32.0 \u00b1 4.0; 19.6 \u00b1 4.9 vs. 25.4 \u00b1 3.8; 15.5 \u00b1 5.5 vs. 20.4 \u00b1 4.7 points, respectively; <jats:italic>P<\/jats:italic> &lt; 0.001), lower analgesia request rate (63.3% vs. 90%; <jats:italic>P<\/jats:italic> = 0.01), lower analgesic consumption (51.6 \u00b1 46.4\u00a0mg vs. 121.6 \u00b1 50.3\u00a0mg of ketoprofen; <jats:italic>P<\/jats:italic> &lt; 0.001), better physical functioning aspect and bodily pain aspect of the quality of life on early recovery (88.4 \u00b1 6.9 vs. 84.6 \u00b1 4.7 and 90.3 \u00b1 4.7 vs. 87.5 \u00b1 5.8; <jats:italic>P<\/jats:italic> = 0.02 and <jats:italic>P<\/jats:italic> = 0.003, respectively), shorter scar length (17.2 \u00b1 2.2\u00a0mm vs. 30.8 \u00b1 4.0\u00a0mm; <jats:italic>P<\/jats:italic> &lt; 0.001), and higher cosmetic satisfaction rate at 1\u00a0month after surgery (85.4 \u00b1 12.4% vs. 77.4 \u00b1 9.7%; <jats:italic>P<\/jats:italic> = 0.006). Cosmetic satisfaction was increasing with time, and there were no significant differences at 6\u00a0months postoperatively. MIVAP was more expensive (US$1,150 \u00b1 63.4 vs. 1,015 \u00b1 61.8; <jats:italic>P<\/jats:italic> &lt; 0.001) while the mean hospital stay was similar (28 \u00b1 10.1 vs. 31.1 \u00b1 9.7 hours; <jats:italic>P<\/jats:italic> = 0.22). Differences in serum calcium values and iPTH during 6\u00a0months of follow\u2010up were nonsignificant. Transient laryngeal nerve palsy appeared in one OMIP patient (<jats:italic>P<\/jats:italic> = 0.31). There was no other morbidity or mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both MIVAP and OMIP offer a valuable approach for solitary parathyroid adenoma with a similar excellent success rate and a minimal morbidity rate. Routine use of the intraoperative iPTH assay is essential in both approaches to avoid surgical failures of overlooked multiglandular disease. The advantages of MIVAP include easier recognition of recurrent laryngeal nerve (RLN), lower pain intensity within 24 hours following surgery, lower analgesia request rate, lower analgesic consumption, shorter scar length, better physical functioning and bodily pain aspects of the quality of life on early recovery, and higher early cosmetic satisfaction rate. However, these advantages are achieved at higher costs because of endoscopic tool involvement.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0312-6","type":"journal-article","created":{"date-parts":[[2006,3,17]],"date-time":"2006-03-17T16:59:55Z","timestamp":1142614795000},"page":"721-731","source":"Crossref","is-referenced-by-count":89,"title":["Minimally Invasive Video\u2010Assisted Parathyroidectomy Versus Open Minimally Invasive Parathyroidectomy for a Solitary Parathyroid Adenoma: A Prospective, Randomized, Blinded Trial"],"prefix":"10.1002","volume":"30","author":[{"given":"Marcin","family":"Barczy\u0144ski","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, 3rd Chair of General Surgery Jagiellonian University College of Medicine 37 Pr\u0105dnicka Street 31\u2010202 Krak\u00f3w Poland"},{"name":"Marcin Barczy\u0144ski 23\/60 Mogilska Street 31\u2013542 Krak\u00f3w 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