Our Summary

This research discusses a new method of surgery used to remove parathyroid glands (small organs located in the neck that control the body’s calcium levels). This procedure, known as a three-port submental endoscopic parathyroidectomy, involves making small openings beneath the chin to perform the surgery, which results in less visible scarring. The study examined the results of five patients who underwent this procedure due to tertiary hyperparathyroidism (a condition where the parathyroid glands produce too much hormone, leading to high calcium levels). The researchers found that after the surgery, patients’ parathyroid hormone and calcium levels decreased significantly. There were no major complications or adverse events, indicating that this new surgical approach is promising and safe.

FAQs

  1. What is a three-port submental endoscopic parathyroidectomy?
  2. What is the benefit of this new surgical method to remove parathyroid glands?
  3. What were the results of the study examining patients with tertiary hyperparathyroidism who underwent the three-port submental endoscopic parathyroidectomy?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about parathyroidectomy is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and monitoring calcium levels. It is important to inform the healthcare team about any unusual symptoms or concerns after surgery. Additionally, maintaining a healthy diet and lifestyle can help support recovery and overall well-being.

Suitable For

Patients who are typically recommended for parathyroidectomy include those with primary hyperparathyroidism (caused by a benign tumor in the parathyroid gland), secondary hyperparathyroidism (due to chronic kidney disease or vitamin D deficiency), and tertiary hyperparathyroidism (persistent high calcium levels despite previous treatment). Symptoms of hyperparathyroidism can include fatigue, bone pain, kidney stones, and high blood pressure. Patients who do not respond to medications or lifestyle changes may be recommended for parathyroidectomy to improve their symptoms and prevent complications from high calcium levels.

Timeline

Before parathyroidectomy:

  • Patient experiences symptoms of hyperparathyroidism, such as fatigue, weakness, bone pain, kidney stones, and high calcium levels.
  • Patient undergoes diagnostic tests, such as blood tests, imaging studies, and possibly a sestamibi scan, to locate the abnormal parathyroid gland(s).
  • Surgeon and patient discuss treatment options, including parathyroidectomy.

During parathyroidectomy:

  • Patient undergoes pre-operative preparations and anesthesia.
  • Surgeon performs the three-port submental endoscopic parathyroidectomy, removing the abnormal parathyroid gland(s) through small incisions beneath the chin.
  • Surgery typically lasts a few hours and is performed under general anesthesia.

After parathyroidectomy:

  • Patient is monitored in the recovery room and may stay in the hospital for a day or two for observation.
  • Patient may experience temporary hoarseness, difficulty swallowing, or neck pain as the incisions heal.
  • Patient’s parathyroid hormone and calcium levels are monitored post-operatively to ensure they return to normal levels.
  • Patient follows up with the surgeon for post-operative care and monitoring.
  • Patient experiences relief from symptoms of hyperparathyroidism and improved overall health and quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a parathyroidectomy?
  2. How long is the recovery period after a parathyroidectomy?
  3. Will I need to take any medications or follow a specific diet after the surgery?
  4. How will my calcium levels be monitored post-surgery?
  5. What follow-up appointments or tests will be necessary after the procedure?
  6. Is there a possibility of the hyperparathyroidism returning after the surgery?
  7. How experienced is the surgical team in performing parathyroidectomies?
  8. Are there any alternative treatment options for my condition?
  9. What can I expect in terms of scarring and cosmetic outcomes following the surgery?
  10. How will this surgery specifically benefit me in managing my hyperparathyroidism compared to other treatments?

Reference

Authors: Piromchai P. Journal: Langenbecks Arch Surg. 2020 Mar;405(2):241-246. doi: 10.1007/s00423-020-01861-8. Epub 2020 Mar 13. PMID: 32170404