Despite the excellent results with bilateral exploration, minimally invasive parathyroidectomy has become the procedure of choice for patients with hyperparathyroidism in which a single parathyroid lesion can be localized preoperatively. In this article, we discuss a patient who presented with primary hyperparathyroidism for the first time and had a Tc‐99m sestamibi scan to localize a single parathyroid lesion in the left, anterior mid‐mediastinum. We subsequently performed a radioguided parathyroidectomy via video‐assisted thoracoscopic surgery (VATS) to resect this parathyroid adenoma and used intraoperative parathyroid hormone (PTH) testing to confirm cure and avoid neck exploration. We concluded that radioguided parathyroidectomy via VATS combined with intraoperative PTH testing is an effective approach for patients with primary hyperparathyroidism and mediastinal parathyroid lesions, and perhaps should be the technique of choice.
尽管双侧甲状旁腺切除术的效果极佳,但微创甲状旁腺切除术已成为甲状旁腺功能亢进症患者的首选手术,因为术前可以对单一甲状旁腺病灶进行定位。本文讨论了一名首次出现原发性甲状旁腺功能亢进症的患者,该患者通过
锝-99m
铯同位素扫描确定了左侧前中纵隔的单发甲状旁腺病灶。随后,我们通过视频辅助胸腔镜手术(VA
TS)实施了放射引导甲状旁腺切除术,切除了这一甲状旁腺腺瘤,并通过术中
甲状旁腺激素(
PTH)检测确认治愈,避免了颈部探查。我们的结论是,对于原发性甲状旁腺功能亢进症和纵隔甲状旁腺病变患者来说,通过VA
TS进行放射引导甲状旁腺切除术并结合术中
PTH检测是一种有效的方法,或许应该成为首选技术。