Department of General, Visceral, Vascular and Thoracic Surgery, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany.
Br J Surg. 2010 Mar;97(3):337-43. doi: 10.1002/bjs.6905.
Mediastinal ectopic parathyroid adenoma is a frequent cause of persistent or recurrent hyperparathyroidism, traditionally treated by open surgery. Thoracoscopic access is associated with reduced morbidity in mediastinal surgery. The aim of this study was to evaluate the feasibility and effectiveness of robot-assisted dissection for mediastinal ectopic parathyroid glands.
Two patients with recurrent secondary hyperparathyroidism and three with complicated primary hyperparathyroidism were operated on between July 2004 and August 2008 for ectopic mediastinal parathyroid glands. Fusion of single-photon emission computed tomography and computed tomography led to an exact identification of the culprit glands. Surgery was performed thoracoscopically with the da Vinci robotic system using a three-trocar approach.
All procedures were completed successfully with the robotic system. No perioperative morbidity or mortality was noted. Median operating time was 58 (range 42-125) min. Intraoperative parathyroid hormone reduction indicated complete resection. Median hospital stay was 3 (range 2-4) days.
Robot-assisted dissection is a promising approach for resection of ectopic parathyroid glands in remote narrow anatomical locations such as the mediastinum.
纵隔异位甲状旁腺腺瘤是持续性或复发性甲状旁腺功能亢进的常见原因，传统上采用开放手术治疗。胸腔镜入路与纵隔手术的发病率降低有关。本研究旨在评估机器人辅助解剖治疗纵隔异位甲状旁腺的可行性和有效性。
2004 年 7 月至 2008 年 8 月期间，对 2 例复发性继发性甲状旁腺功能亢进症和 3 例复杂原发性甲状旁腺功能亢进症患者进行了手术，以治疗纵隔异位甲状旁腺。单光子发射计算机断层扫描和计算机断层扫描融合可准确识别罪魁祸首腺体。手术采用达芬奇机器人系统进行胸腔镜下三套管入路。
所有手术均成功完成，无围手术期并发症或死亡。中位手术时间为 58 分钟（范围 42-125 分钟）。术中甲状旁腺激素减少表明完全切除。中位住院时间为 3 天（范围 2-4 天）。
机器人辅助解剖是一种有前途的方法，可用于切除纵隔等远程狭窄解剖部位的异位甲状旁腺。
