This paper is only available as a PDF. To read, Please Download here.
Abstract
Background. Most abnormal parathyroid glands can be removed through the neck, but those deep
in the chest have required sternotomy or thoracotomy. To avoid the morbidity of these
open procedures, ectopic parathyroid glands deep in the chest were removed with video-assisted
thoracoscopy.
Methods. Two patients with persistent primary and two with persistent secondary hyperparathyroidism
had technetium-thallium scintigraphy and computed tomography of the chest to localize
their ectopic glands. Video-assisted thoracoscopy was used for operative removal of
these glands in each patient.
Results. Parathyroid scans identified a mediastinal gland that was confirmed and localized
precisely by the computed tomography scan. An enlarged ectopic gland weighing 1 to
2 gm was removed from each patient with normalization of serum calcium level. Glands
were found by the main pulmonary artery, aortopulmonary window, ascending aorta, and
aortic arch. One patient had recurrent disease 9 months later.
Conclusions. Removal of parathyroid glands deep in the chest with video-assisted thoracoscopy
is a safe and successful alternative to median sternotomy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Primary hyperparathyroidism in the 1990s.Ann Surg. 1992; 215: 300-317
- Transcervical thymectomy.Arch Surg. 1975; 111: 359-364
- Mediastinal parathyroid tumors.Arch Surg. 1988; 123: 1096-1100
- The mediastinal parathyroid.Am Surg. 1991; 57: 62-66
- Mediastinal parathyroid tumors.Ann Surg. 1981; 193: 805-809
- Long-term follow-up of patients with hyperparathyroidism treated with transcatheter staining with contrast agent.Surgery. 1983; 94: 849-862
- Angiographic ablation of mediastinal parathyroid adenoma.Ann Surg. 1992; 215: 99-100
- Mediastinal masses.in: Kaiser L.R. Daniel T.M. Thoracoscopic surgery. Little, Brown, Inc, Boston1993: 163-175
- Technetiumthallium scintiscanning for localization of parathyroid adenomas and hyperplasia.Am J Surg. 1987; 153: 479-486
- The detection of mediastinal parathyroid glands by computed tomography, selective arteriography, and venous sampling.Radiology. 1981; 140: 739-744
- The story of hyperparathyroidism at the Massachusetts General Hospital.N Engl J Med. 1966; 274: 1174-1182
- Closed mediastinal exploration in patients with persistent hyperparathyroidism.Ann Surg. 1991; 214: 555-561
- Results of multidisciplinary strategy for management of mediastinal parathyroid adenoma as a cause of persistent primary hyperparathyroidism.Ann Surg. 1992; 215: 101-106
- Resection of parathyroid tumor in the aorticopulmonary window without prior neck exploration.Surgery. 1988; 104: 1090-1094
- Hyperfunctioning supernumerary parathyroid glands.in: 2nd ed. Mayo Clin Proc. 57. 1982: 121-124
- Reoperation for persistent recurrent hyperparathyroidism.Ann Surg. 1985; 201: 40-44
- Prospective comparison of technetium-99nm-sestamibi jodine-123 radionuclide scan versus high-resolution ultrasonography forthe preoperative localization of abnormal parathyroid glands in patients with previously unoperated primary hyperparathy-roidism.Am J Surg. 1993; 166: 369-373
Article info
Footnotes
☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.
Identification
Copyright
© 1994 Published by Elsevier Inc.
