Minimally invasive parathyroidectomy using intraoperative ultrasonographic localization for primary hyperparathyroidism in pregnancy: report of two cases
Mehmet Haciyanlı, Emine Özlem Gür, Hüdai Genç, Selda Gücek Haciyanlı, Fatma Tatar, Turan Acar, Serkan Karaisli
Clinic of General Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
Abstract
Primary hyperparathyroidism (pHPT) in pregnancy is a rare entity associated with increased maternal and fetal mortality and morbidity. Diagnosis of pHPT is challenging in pregnancy. Approximately 80% of the cases are asymptomatic, while the most common symptoms are nausea, vomiting, polyuria, polydypsia, and cloudy vision in symptomatic patients. Since the most common cause of pHPT in pregnancy is adenoma, such in the general population, focused anterior or lateral approach is recommended due to shorter operation time, less risk for the fetus, and lower complication risk. Performing intraoperative ultrasonography to do the incision just over the adenoma provides quicker access to the adenoma and intraoperative parathormone assay confirms the surgical cure. Laryngeal mask anesthesia causes lesser sore throat, laryngospasm, coughing, and rapid recovery as compared to endotracheal intubation anesthesia. This study aimed to present the management of two pregnant patients diagnosed with pHPT and who underwent minimally invasive parathyroidectomy under intraoperative ultrasonography and laryngeal mask anesthesia at the second trimester of gestation. To the best of our knowledge, parathyroidectomy under laryngeal mask anesthesia in pregnancy has never been described before.
Keywords: Intraoperative ultrasonography, laryngeal mask anesthesia, minimally invasive parathyroidectomy, pregnancy, gestational hyperparathyroidism
Cite this article as: Haciyanli M, Gür EÖ, Genç H, Gücek Haciyanli S, Tatar F, Acar T, Karaisli S. Minimally invasive parathyroidectomy using intraoperative ultrasonographic localization for primary hyperparathyroidism in pregnancy: report of two cases. Turk J Surg 2019; 35 (3): 231-235.
Written informed consent was obtained from all the patients who participated in this study.
Externally peer-reviewed.
Concept - M.H., S.K.; Design - E.O.G., H.G.; Supervision - M.H., H.G.; Resource - S.G.H., E.O.G.; Materials - S.G.H., S.K.; Data Collection and/or Processing - T.A., S.K.; Analysis and/or Interpretation - H.G., F.T.; Literature Search - T.A., F.T.; Writing Manuscript - S.K., M.H.; Critical Reviews - M.H., H.G., F.T.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.