Endocrine Abstracts

Background: Bilateral neck exploration (BNE) as a routine surgery for PHPT is favored by many experts in endocrine surgery as it may provide the identification of preoperatively undetected multiglandular disease. But for a large cohort of patients BNE remains unnecessary and its possible higher rate of surgical complications is being widely discussed.

Objectives: The aim of the study was to evaluate the complication rates of bilateral neck exploration in comparison with focused parathyroidectomy.

Methods: 408 patients who underwent an initial surgery for PHPT at SPBU Hospital in 2020 were included in the study. PTH level on the 1st day after surgery, histological reports, postoperative laryngoscopy and surgery protocols were evaluated. Intraoperative PTH level was not measured. Cases of persistent PHPT, parathyroid carcinomas and cases with more than one histologically confirmed adenoma were excluded. Number of cases included in the study was 389.

Results: Number of groups of BNE and FPTX was 287 and 102 respectively. There was no statistically significant difference in postoperative PTH level (1.6 + 1.00 vs 1.8 + 1.13 pmol/l, P-value = 0.183) and operation time (33.9 + 13.8 vs 32.4 + 12.7 min, P-value = 0.623. No contralateral vocal cord palsy was reported in the group of BNE.

Conclusions: BNE performed by an experienced endocrine surgeon may be as safe as PTX and also be comparable by the duration of the operation