Endoscopic parathyroidectomy versus open parathyroidectomy for patients with refractory secondary hyperparathyroidism: a meta-analysis

Wei Xu; Guoyuan Lu; Lifeng Gong; Weigang Tang; Jingkui Lu

doi:10.5114/wiitm.2023.132439

Endoscopic parathyroidectomy versus open parathyroidectomy for patients with refractory secondary hyperparathyroidism: a meta-analysis

Wideochir Inne Tech Maloinwazyjne. 2023 Dec;18(4):578-587. doi: 10.5114/wiitm.2023.132439. Epub 2023 Oct 27.

Authors

Wei Xu^{1

2}, Guoyuan Lu³, Lifeng Gong^{1

2}, Weigang Tang^{1

2}, Jingkui Lu^{1

2}

Affiliations

¹ Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.
² Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China.
³ Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Abstract

Introduction: Endoscopic parathyroidectomy(EPTX) has been gradually introduced as a minimally invasive treatment for refractory secondary hyperparathyroidism (SHPT). However, it is uncertain about the efficacy and safety compared between EPTX and open parathyroidectomy (OPTX) for refractory SHPT.

Aim: This meta-analysis was conducted to evaluate the efficacy and safety of EPTX and OPTX for secondary hyperp arathyroidism (SHPT).

Material and methods: Databases including PubMed, EMbase, Cochrane Library, CNKI, and Wanfang were searched. Eligible studies comparing EPTX and OPTX for refractory SHPT were included.

Results: Compared with OPTX, EPTX has the shorter hospital stay (p < 0.01) and lower incidences of hoarseness or recurrent laryngeal nerve injury (p = 0.04). There was no significant difference between EPTX and OPTX concerning operation time (p = 0.49), intraoperative blood loss (p = 0.24), postoperative parathyroid hormone levels (p = 0.22), postoperative calcium levels (p = 0.93), postoperative phosphorus levels (p = 0.37), and complications including neck ecchymosis (p = 0.87), subcutaneous haematoma (p = 0.18), and wound infection (p = 0.11).

Conclusions: EPTX and OPTX are both effective methods for refractory SHPT. EPTX had the shorter hospital stay and lower incidences of hoarseness or recurrent laryngeal nerve injury.

Keywords: endoscopic parathyroidectomy; meta-analysis; open parathyroidectomy; secondary hyperparathyroidism.