Özer MAKAY, Varlık EROL, Gökhan İÇÖZ, Şafak ÖZTÜRK, Övünç AKDEMİR, Mahir AKYILDIZ

Cosmetic aspects in minimally invasive parathyroidectomy: Is minimally invasive approach superior?

Aim: The aim of this study was to determine whether minimally invasive parathyroid surgery has any positive impact on cosmesis. Materials and Methods: This case control study included 28 parathyroidectomized patients, who had been operated between January 2006 – December 2008. All patients were called back for at least 8 months after surgery. Demographics were recorded. Minimally invasive parathyroidectomy versus conventional parathyroidectomy were compared by means of skin features (using Fitzpatrick’s classification), results of patient and independent observer scar assessment scales and photographic scar analysis by the blinded plastic surgeon. Results: There were no differences in demographics and Fitzpatrick’s classification between both groups. As expected, incision length of the minimal invasive group was significantly shorter (2.6±0.5cm vs. 4.9±1.0 cm, p=0.02). Meanwhile, no significant difference in objective outcomes of patients between groups was recorded. There was also no significant difference in photographic scar analysis between groups, while independent observer scar assessment scale scores were better in the minimal invasive group (p=0.03). Conclusion: Although superior results of an independent observer, assessment of cosmesis by the plastic surgeon and the patient him/herself revealed no superiority of the minimally invasive approach, when compared to conventional parathyroid surgery.

Kozmetik yönüyle minimal invaziv paratiroidektomi: Minimal invaziv yaklaşım daha mı üstün?

Amaç: Bu çalışmanın amacı minimal invaziv paratiroidektominin kozmeziz üzerine olumlu bir etkisinin olup olmadığının belirlenmesidir. Gereç ve Yöntem: Bu olgu kontrol çalışması, Ocak 2006-Aralık 2008 tarihleri arasında opera edilen 28 paratiroidektomili hastayı kapsamaktadır. Tüm hastalar operasyondan en az 8 ay sonra kontrole çağırıldı. Demografik verileri kaydedildi. Minimal invaziv paratiroidektomi ve konvansiyonel paratiroidektomi, operasyon sonrası cilt özellikleri açısından (Fitzpatrick’s sınıflaması kullanılarak belirlenen) bir plastik cerrah tarafından hasta sonuçları ve bağımsız gözlemci skar değerlendirme skalası, fotografik skar analizi vasıtasıyla karşılaştırıldı. Bulgular: İki grup arasında demografik veriler ve Fitzpatrick’s sınıflaması açısından farklılık saptanmadı. Beklendiği gibi minimal invaziv grubun insizyon uzunluğunun daha kısa olduğu belirendi (2.6±0.5 cm’ye 4.9±1.0 cm; p=0.02). Iki grup arasında objektif sonuçlar açısından anlamlı bir fark belirlenmedi. Fotografik skar analizi açısından iki grup arasında anlamlı bir fark belirlenmezken, bağımsız gözlemci skar değerlendirme skalası sonuçlarının minimal invaziv cerrahi grubunda daha iyi olduğu belirlendi (p=0.03). Sonuç: Bağımsız bir gözlemci tarafından daha iyi sonuçlar olduğu belirtilse de, kozmetik sonuçlar bir plastik cerrah ve hasta tarafından değerlendirildiğinde minimal invaziv cerrahinin konvansiyonel cerrahiye göre bir üstünlüğünün olmadığı belirlendi.

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