Does the intraoperative parathormone monitoring really affect surgical success in primary hyperparathyroidism?
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis Ltd
Access Rights
info:eu-repo/semantics/closedAccess
Abstract
Background Surgery is the only curative treatment option for primary hyperparathyroidism (PHPT). The intraoperative parathormone (IOPTH) monitoring is recommended to confirm that all pathological glands have been removed. This study aimed to evaluate the effect of IOPTH monitoring on the surgical success of parathyroidectomy performed for PHPT. Methods The demographic, biochemical, operative and pathological data of patients who underwent parathyroidectomy for PHPT in a single institute over a three-year period were retrospectively analyzed. Results The total number of patients included in the study was 182. The IOPTH monitoring had been performed in 92 patients (50.5%). The IOPTH monitoring had a clinical accuracy of 89.2%, sensitivity of 89.8%, and specificity of 75%. The rate of surgical success was 95.7% in the group with IOPTH monitoring and 91.1% in the group without this monitoring (p = .21). Of the 40 patients who underwent minimally invasive parathyroidectomy (MIP), 25 patients had IOPTH monitoring, and the surgery was successful for all these patients (100%). Surgical success was achieved in 14 (93.3%) patients who underwent MIP without IOPTH monitoring (p = .37). Conclusion The IOPTH monitoring is a reliable test with high accuracy. The lack of IOPTH monitoring may result in lower than acceptable surgical success rates. Even though preoperative localization studies are compatible with surgical findings, the IOPTH monitoring should also be undertaken, especially in patients scheduled for MIP for PHPT.
Description
Keywords
Primary hyperparathyroidism, parathyroidectomy, parathormone, intraoperative monitoring
Journal or Series
Acta Chirurgica Belgica
WoS Q Value
Q4
Scopus Q Value
Q3
Volume
123
Issue
2
