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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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vol. 18
General surgery

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

Wei Xu
1, 2
Guoyuan Lu
Lifeng Gong
1, 2
Weigang Tang
1, 2
Jingkui Lu
1, 2

Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
Videosurgery Miniinv 2023; 18 (4): 578–587
Online publish date: 2023/10/27
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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.

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.

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).

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.


secondary hyperparathyroidism, meta-analysis, open parathyroidectomy, endoscopic parathyroidectomy

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