Evidence map›Paper›PMID 34741203›Full record

ArticleSurgical endoscopy2022

One hundred and one consecutive transoral endoscopic parathyroidectomies via the vestibular approach for PHPTH: a worldwide multi-institutional experience.

Raymon H Grogan, Avi K Khafif, Assadi Nidal, Angkoon Anuwong, Mohammad Shaear, Christopher R Razavi, Jonathon O Russell, Ralph P Tufano

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Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Raymon H Grogan *Section of Endocrine Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Avi K Khafif *Head and Neck Surgery Unit, A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Ben Gurion University of the Negev, Tel Aviv, Israel.
Assadi NidalHead and Neck Surgery Unit, A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Ben Gurion University of the Negev, Tel Aviv, Israel.
Angkoon AnuwongMinimally Invasive and Endocrine Surgery Division, Department of Surgery, Police General Hospital, Bangkok, Thailand.
Mohammad ShaearDivision of Head and Neck Endocrine Surgery, Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline 6th Floor, Baltimore, MD, 21287, USA.
Christopher R RazaviDivision of Head and Neck Endocrine Surgery, Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline 6th Floor, Baltimore, MD, 21287, USA.
Jonathon O RussellDivision of Head and Neck Endocrine Surgery, Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline 6th Floor, Baltimore, MD, 21287, USA. Jrusse41@jh.edu.ORCID http://orcid.org/0000-0003-2903-9649
Ralph P TufanoDivision of Head and Neck Endocrine Surgery, Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline 6th Floor, Baltimore, MD, 21287, USA.
Johns Hopkins University · USBen-Gurion University of the Negev · ILBaylor College of Medicine · USPolice General Hospital · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceThe transoral vestibular approach for thyroid and parathyroid surgery is being adopted rapidly world-wide. Currently there is a paucity of information on this approach for primary hyperparathyroidism (PHPTH). If this approach is safe and efficacious it would provide patients a completely scarless option for parathyroidectomy.

objectiveTo determine whether parathyroidectomy via the transoral vestibular approach can be successfully done in a safe and efficient manner.

designConsecutive case series of 101 transoral parathyroidectomies performed over a two-year period.

settingMulti-institutional, academic, high-volume transoral thyroidectomy centers from the USA, Israel, and Thailand.

participantsA consecutive series of adult patients with a biochemical diagnosis of classic PHPTH and who met criteria for parathyroidectomy based on established international consensus for surgery for PHPTH. All patients also had well-localized single adenomas on at least two preoperative imaging studies.

interventionTransoral endoscopic parathyroidectomy vestibular approach. MAIN OUTCOMES AND MEASURES: Surgical success rate defined by immediate intra or post-operative return to normal PTH values. Surgical complications including recurrent laryngeal nerve injury, permanent hypoparathyroidism, and infection.

resultsOf the 101 consecutive transoral parathyroidectomy patients 84% were female with an average age of 54.23 ± 11.0 years and an average BMI of 27.35 ± 6.19. Ninety-nine out of the 101 patients had immediate return to normal PTH after resection for a surgical success rate of 98%. There were no permanent recurrent laryngeal nerve injuries, one temporary nerve palsy, and no permanent hypoparathyroidism. The median operative time dropped from 130.5 min (IQR 86) to 66.5 min (IQR 56) between the first- and second-half of cases. CONCLUSION AND RELEVANCE: Transoral endoscopic parathyroidectomy via the vestibular approach is a scarless method of removing parathyroids that is clinically feasible, safe, and efficacious and is a reasonable option for focused minimally invasive parathyroidectomy that can be offered to select patients with PHPTH.

Indexed as

HypoparathyroidismNatural Orifice Endoscopic SurgeryRecurrent Laryngeal Nerve InjuriesAdultAgedEndoscopyFemaleHumansMaleMiddle AgedParathyroidectomyParathyroid GlandsThyroidectomyParathyroidectomyParathyroid surgeryRemote access parathyroidectomyTOEPVATransoral Endoscopic Parathyroidectomy

Identifiers

PMID34741203
OpenAlexW3209445377

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.