SURGICAL MANAGEMENT OF PARATHYROID PATHOLOGY: EXPERIENCE IN SINGLE CENTER WITH DIFFERENT TECHNOLOGICAL RESOURCES. rociosanchezmalo@gmail.com

 

SURGICAL MANAGEMENT OF PARATHYROID PATHOLOGY: EXPERIENCE IN SINGLE CENTER WITH DIFFERENT TECHNOLOGICAL RESOURCES.

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Javier Luis Rossi rociosanchezmalo@gmail.com Hospital Militar Central CABA Argentina

Argentina

Oral or Poster

Hyperparathyroidism (HPT) is an endocrine disorder that can cause significant complications, including alterations in calcium-phosphorus metabolism with an impact on cardiovascular, bone, and renal health. Our objective is to analyze the surgical management of parathyroid pathology in patients with primary (PHPT), secondary (SHPT), and tertiary (THPT) hyperparathyroidism at a single health center.

Retrospective observational cohort study, reviewing 37 patients between January 2018 and April 2025. Surgical treatments and short- and medium-term follow-up were analyzed. Intraoperative neuromonitoring (IONM) was used in all patients, and indocyanine green was used in 18 cases.

Thirty-seven cases were analyzed; 29 patients with PHTP (78.4%), 7 with HPTS (18.9%), and 1 case of HPTT (2.7%). Fifteen cervicotomies with bilateral exploration, 11 minimal cervicotomies, and 11 transoral endoscopic parathyroidectomies via a vestibular approach (TOEPVA) were performed. Five patients (13.5%) presented with hypocalcemia and 3 (8.1%) with transient dysphonia; no wound infections were reported. At 30 days postoperatively, 86.5% achieved normalization of serum calcium.

At PHTP, the use of a minimally invasive method is recommended provided that the parathyroid adenoma is correctly located preoperatively. The TOEPVA technique proved to be a safe method, with a high rate of serum calcium normalization and a low complication rate. Bilateral cervical exploration is recommended in cases of parathyroid hyperplasia, ectopic locations, and cases where the images are not conclusive. The use of indocyanine green could optimize the results.