Videothoracoscopic excision of mediastinal parathyroid adenoma in primary hyperparathyroidism

Česká verzia

Authors: P. Libánský ¹; P. Broulík ²; M. Fialová ¹; J. Kubinyi ³; R. Lischke ¹ ; D. Táborská ⁴; J. Tvrdoň ¹; J. Šedý ⁵; S. Adámek ¹
Authors place of work: III. chirurgická klinika 1. LF Univerzity Karlovy a FN Motol, Praha přednosta: prof. MUDr. R. Lischke, PhD. ¹; III. Interní klinika 1. LF Univerzity Karlovy a VFN, Praha přednosta: prof. MUDr. Š. Svačina, DrSc., MBA ²; Ústav nukleární medicíny 1. LF Univerzity Karlovy a VFN, Praha přednosta: prof. MUDr. M. Šámal, DrSc. ³; Klinika nukleární medicíny a endokrinologie 2. LF Univerzity Karlovy a FN Motol, Praha přednosta: prof. MUDr. P. Vlček, CSc. ⁴; Ústav normální anatomie, LF Univerzity Palackého v Olomouci přednosta ústavu: doc. RNDr. P. Mlejnek, Ph. D. ⁵
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 6, s. 245-248.
Category: Kazuistika

Summary

Introduction:
Primary hyperparathyroidism is a disease caused by elevated secretion of parathyroid hormone from pathological parathyroid glands. After the diagnosis, the success of its surgical solution depends predominantly on surgical management and experience of the surgeons. A special group is formed by ectopic localizations of pathologically enlarged parathyroid glands in the mediastinum, which require a modified surgical approach. When the adenoma is deep in the mediastinum, sternotomy or thoracotomy is indicated; alternatively, a minimally invasive approach can be used – videothoracoscopic thymectomy.

Case report:
We present a case of a patient with normocalcemic recurrent primary hyperparathyroidism. This patient underwent a minimally invasive video-assisted thymectomy after scintigraphic confirmation of parathyroid adenoma in the mediastinum.

Conclusion:
The removal of parathyroid adenoma in the mediastinum using the videothoracoscopic method is safe. Compared to sternotomy, this method improves the postoperative period, reduces the length of stay and provides more comfort to patients. We recommend considering the videothoracoscopic method in cases where the pathologically enlarged parathyroid gland is localized in the inferior and anterior mediastinum.

Key words:
primary hyperparathyroidism −adenoma of glandula parathyroidea – mediastinum − miniinvasive

Zdroje

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