Immediate and long-term results of surgical treatment of primary hyperparathyroidism from standard and small access

• Alexsandr V. Ogorodnikov
• Kharnas S.S.

Abstract

Background. The paper presents a retrospective analysis of the immediate and long-term results of surgical treatment of PGPT from standard and small-access surgical manuals. The assessment of the quality of life of patients was carried out, which today is a necessary link for optimizing therapeutic and diagnostic tactics. Based on the data obtained, the conclusion is valid about the prospects of using "gentle" approaches of surgical treatment.

Aim. Improving the results of surgical treatment of patients with PGPT based on the analysis of the immediate and long-term results of parathyroidectomy from standard and small access.

Material and methods. A retrospective study of the immediate and long-term results of surgical treatment and the quality of life of patients with an established diagnosis of PGPT was conducted. The work was carried out on the basis of inpatient treatment of the patient and his subsequent follow-up in the postoperative period with an assessment of immediate and long-term results using the SF-36 questionnaire and a linear analog scale (LAS). Statistical analysis was performed in the R programming language using the FMSB package, where the calculated data of the results were presented graphically (bar charts, spider plot and barplot).

Results. The present study involved 370 patients with an established diagnosis of PGPT. Initially, the patients were divided into 2 groups depending on the access of surgical treatment. Early results after parathyroidectomy, regardless of access, were similar (the recurrence rate in GR1 and GR2, respectively, was 4.5 and 3.6%, the persistence rate was 44.4 and 55.5%). When assessing the quality of life using the SF-36 questionnaire after surgery, an improvement was noted in both groups, but a significant difference for the better was noted in terms of GH (General Health) and VT (Vitality) in patients operated from small access (GR2). Also, the LAS index of patients with GR2 is significantly higher in comparison with GR1.

Conclusion. The results of the study showed the prospects of using a gentle approach to the surgical treatment of PGPT.

Keywords:primary hyperparathyroidism, parathyroid glands, hypercalcemia, parathyroid hormone, adenoma, Kocher access, small access, parathyroidectomy, quality of life, questionnaire SF-36, LAS

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