Retrospective analysis of the role of intra-operative parathyroid
hormone monitoring during parathyroidectomy for primary
hyperparathyroidism; a single center experience over 2 decades
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.