Cosmetic aspects in minimally ınvasive 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.