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Retrospective analysis of the role of intra-operative parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism; a single center experience over 2 decades
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  • Yehonatan Adler,
  • Sharon Tzelnick,
  • Yoni Shopen,
  • Ella Reifen,
  • Gideon Bachar,
  • Thomas Shpitzer,
  • Aviram Mizrachi
Yehonatan Adler
Rabin Medical Center
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Sharon Tzelnick
Rabin Medical Center
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Yoni Shopen
Rabin Medical Center
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Ella Reifen
Rabin Medical Center
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Gideon Bachar
Rabin Medical Center
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Thomas Shpitzer
Rabin Medical Center
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Aviram Mizrachi
Rabin Medical Center
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Abstract

Background: The role of intra-operative parathyroid hormone (IOPTH) monitoring during parathyroidectomy for primary hyperparathyroidism has long been debated. Objectives: Our main goal was to investigate the cure rates of parathyroidectomy for primary hyperparathyroidism with and without IOPTH monitoring. Our secondary goal was to investigate if operating room time can be saved when not using IOPTH monitoring. Design: A retrospective analysis of patients who underwent parathyroidectomy for PHPT for a single adenoma between 2004-2019 was performed. Cure rates and operating room time were compared. Results: 423 patients were included. IOPTH was used in 248 patients (59%). Four patients were not cured, two from each group, with no significant difference between the groups (98.8% vs. 99.1%, p=0.725). Surgery time was significantly longer in the IOPTH group, p<0.001. Conclusions: There is no advantage for using IOPTH during parathyroidectomy in suitable clinical setting. A focused procedure may be safely performed without IOPTH while achieving non-inferior success rates and reducing operative time.

Peer review status:UNDER REVIEW

14 Nov 2021Submitted to Clinical Otolaryngology
22 Nov 2021Assigned to Editor
22 Nov 2021Submission Checks Completed
07 Dec 2021Reviewer(s) Assigned
05 Jan 2022Review(s) Completed, Editorial Evaluation Pending