International Journal of Clinical Research

Objective To compare the clinical efficacy of endoscopic parathyroidectomy via the infraclavicular approach and traditional open surgery in the treatment of single parathyroid adenoma, focusing on evaluating the differences between the two surgical methods in terms of minimally invasiveness, functional recovery and patient satisfaction. Methods A retrospective cohort study design was adopted. A total of 40 patients with single parathyroid adenoma admitted to the Department of Surgery of Jiangyuan Hospital of Jiangsu Province from January 2023 to May 2025 were included and divided into the endoscopic group (20 cases) and the open group (20 cases). The intraoperative indicators, postoperative recovery indicators, biochemical indicators and patients' subjective evaluation of the two groups were compared and analyzed. Statistical analysis was performed using SPSS 26.0 software. Measurement data were expressed as mean ± standard deviation, and independent sample t-test was used for comparison between groups; counting data were expressed as frequency, and χ² test or Fisher's exact test was used for comparison between groups. The significance level was set at P<0.05. Results The intraoperative blood loss in the endoscopic group was significantly lower than that in the open group (5.0±0.0ml vs 9.5±5.2ml, P<0.001). The postoperative drainage volume (58.5±20.1ml vs 72.3±24.8ml, P=0.038) and hospital stay (5.1±1.2 days vs 6.3±1.5 days, P=0.007) in the endoscopic group were significantly reduced. In patients' subjective evaluation, the proportion of "very satisfied" with cosmetic satisfaction (85% vs 30%, P<0.001) and the proportion of "very satisfied" with neck sensation satisfaction (75% vs 25%, P=0.002) in the endoscopic group were significantly better than those in the open group. There were no complications such as hoarseness, bleeding and incision infection in both groups after operation. Conclusion Endoscopic surgery via the infraclavicular approach has significant advantages in minimally invasiveness, postoperative recovery speed and patients' subjective experience, and is especially suitable for young patients sensitive to appearance. Clinical decision-making should be combined with patients' individual needs, lesion complexity and medical resource conditions. In the future, endoscopic technology should be further optimized to shorten the learning curve and reduce costs, so as to promote the wide application of minimally invasive surgery.

Parathyroid adenoma; Subclavian approach; Laparoscopic surgery; Open surgery; Clinical efficacy