The influence of surgical approach on quality of life after parathyroid surgery.

Abstract

It is well established that quality of life improves after parathyroidectomy. Less well understood is the impact of surgical approach on quality of life during recovery. This study was undertaken to determine whether surgical approach influences quality of life after surgery for hyperparathyroidism. A total of 146 consecutive patients who underwent surgery for hyperparathyroidism were administered the SF-36 Health Survey 1 week before, 1 week after, and 1 year after surgery. Ninety-eight patients had minimally invasive parathyroidectomies, while 48 patients had bilateral explorations. All patients were normocalcemic > 6 months after surgery. Hospital length of stay was significantly shorter in those undergoing a minimally invasive operation (mean +/- SE, .2 +/- .0 vs. .9 +/- .0 days, P < .001). The rate of complications was not statistically different (3.1% vs. 6.3%, P = .40). Quality of life improved after surgery for hyperparathyroidism, irrespective of surgical approach. The minimally invasive group greatly improved in four scales 1 week after operation, while those with a bilateral exploration improved in two. After 1 year, the minimally invasive group had statistically improved in eight categories, while the bilateral exploration group did so in only four (P < .05 for all). With improvements in surgical outcomes and quality of life, these data provide additional evidence that minimally invasive parathyroidectomy is the operation of choice for patients with hyperparathyroidism.