Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta.
J Otolaryngol Head Neck Surg. 2010 Aug;39(4):361-9.
To compare minimally invasive parathyroidectomy (MIP) under local anesthesia (MIPULA) to minimally invasive parathyroidectomy performed under general anesthesia (MIPUGA) in terms of postoperative pain, postanesthetic side effects, patient satisfaction, and overall outcome.
Prospective comparative cohort study.
Consecutive consenting patients presenting to a single surgeon's practice were enrolled into MIPULA or MIPUGA groups if inclusion criteria were satisfied. A standard anesthesia and surgical protocol was followed for all included patients. Subjective outcome measurements (pain, overall satisfaction, and other variables) were achieved through questionnaires. Objective outcomes were also measured.
Seventy-four patients were enrolled: 58 in the MIPULA group and 16 in the MIPUGA group. Operative time and hospital stay were significantly shorter in the MIPULA group. Subjectively, the MIPULA group was significantly more ready for discharge versus the MIPUGA group. No significant difference in overall satisfaction between groups was noted. Biochemical cure and conversion (MIPULA to general anesthesia open exploration) rates for our cohort were 100% and 4%, respectively.
MIPULA confers significantly shorter operative time and hospital stay with no significant difference in subjective postoperative pain, patient satisfaction, overall outcome, or cure rate when compared to MIPUGA. Provided that appropriate preoperative localization and surgical experience are present, MIPULA can be offered to patients as a safe and reasonable alternative to MIPUGA.
比较局部麻醉下微创甲状旁腺切除术（MIPULA）与全身麻醉下微创甲状旁腺切除术（MIPUGA）在术后疼痛、麻醉后副作用、患者满意度和总体结果方面的差异。
前瞻性对比队列研究。
连续同意参与的患者，如果符合纳入标准，将被纳入 MIPULA 或 MIPUGA 组。所有纳入的患者均遵循标准的麻醉和手术方案。通过问卷调查获得主观结果测量（疼痛、总体满意度和其他变量）。同时也测量了客观结果。
共纳入 74 例患者：MIPULA 组 58 例，MIPUGA 组 16 例。MIPULA 组的手术时间和住院时间明显更短。主观上，MIPULA 组相较于 MIPUGA 组更适合出院。两组在总体满意度方面无显著差异。本队列的生化治愈率和转换率（MIPULA 转为全身麻醉开放探查）分别为 100%和 4%。
与 MIPUGA 相比，MIPULA 具有明显更短的手术时间和住院时间，术后疼痛、患者满意度、总体结果或治愈率方面无显著差异。只要有适当的术前定位和手术经验，MIPULA 可以作为一种安全合理的替代方案提供给患者。
