Objective To compare the clinical effects of unilateral neck exploration (UNE) and direct minimally invasive parathyroidectomy (DPT) in the treatment of primary hyperparathyroidism (PHPT). Methods The clinical datas of 87 PHPT patients treated with intraoperative parathyroid hormone monitoring (IPM) -assisted UNE and DMIP in Guizhou Provincial People’s Hospital between January 2016 and December 2021 were analyzed retrospectively. Results The average age of patients was (47.5±13.1) years, and there were 24 males (27.6%) and 63 females (72.4%). The pathological types of 87 cases were parathyroid adenoma in 78 cases (89.7%), atypical parathyroid adenoma in 5 cases (5.7%), parathyroid hyperplasia in 4 cases (4.6%), and no parathyroid carcinoma. Two cases (2.3%) developed recurrent laryngeal nerve injury, and 3 cases (3.4%) developed postoperative persistent hyperparathyroidism, of which 1 (1.1%) case underwent secondary surgery. There were no significant differences in the incidence of recurrent laryngeal nerve injury (2.0% vs. 2.6%, P=0.855) and postoperative persistent hyperparathyroidism between the UNE group and the DMIP group (2.0% vs. 5.3%, P=0.713). However, the intraoperative bleeding volume, operative time, hospitalization time, incision length, and pain score in the DMIP group were significantly less than or shorter than or lower than those in the UNE group (P<0.001). Conclusion There is no significant difference in the efficacy between the DMIP and UNE in the treatment of PHPT, but DMIP can significantly shorten the operative time and hospitalization time, and reduce the trauma.

Citation： ZENG Yanzhang, YU zhaoyan, YUAN Ping. Retrospective comparative analysis of unilateral neck exploration and direct minimally invasive parathyroidectomy in the treatment of primary hyperparathyroidism. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(12): 1478-1482. doi: 10.7507/1007-9424.202308078 Copy