Evidence map›Paper›PMID 35403873›Full record

ArticleWorld journal of surgery2022

Minimally Invasive Parathyroidectomy: Can Intraoperative Parathyroid Hormone Monitoring be Omitted?

Shalom Eligal, Michal Mekel, Jeffrey M Weinberger, Mariya Neymark, Nir Hirshoren, Ido Mizrahi, Ron Eliashar, Haggi Mazeh

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Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Shalom Eligal *Hadassah Hebrew-University School of Medicine, Jerusalem, Israel.
Michal Mekel *Department of Surgery, Rambam-Health Care Campus, Haifa, Israel.
Jeffrey M WeinbergerHadassah Hebrew-University School of Medicine, Jerusalem, Israel.
Mariya NeymarkDepartment of Surgery, Rambam-Health Care Campus, Haifa, Israel.
Nir HirshorenHadassah Hebrew-University School of Medicine, Jerusalem, Israel.
Ido MizrahiHadassah Hebrew-University School of Medicine, Jerusalem, Israel.
Ron Eliashar *Hadassah Hebrew-University School of Medicine, Jerusalem, Israel.
Haggi Mazeh *Hadassah Hebrew-University School of Medicine, Jerusalem, Israel. hmazeh@hadassah.org.il.
Hebrew University of Jerusalem · ILHadassah Medical Center · ILRambam Health Care Campus · ILTechnion – Israel Institute of Technology · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntraoperative PTH (ioPTH) monitoring has become widely accepted in the era of minimally invasive parathyroidectomy (MIP). The purpose of this study was to evaluate the need for ioPTH during parathyroidectomy in patients with positive preoperative imaging.

methodsThe charts of patients who underwent parathyroidectomy at three tertiary centers between the years 2012 and 2021 were retrospectively reviewed. Patients were defined as MIP candidates with either concordant preoperative imaging or a single positive imaging. Patients with negative or discordant imaging, concomitant thyroidectomy, or previous neck surgery were excluded.

resultsOf a total of 1013 patients who underwent parathyroidectomy, 535 (52.8%) were defined as MIP candidates and were included in the statistical analysis. Surgical success was achieved in all patients. A single adenoma that corresponded to the preoperative imaging was identified and resected in 517 (93.8%) patients. In only 18 (3.3%) patients, the ioPTH correctly changed the operative management where additional pathologic glands were identified and excised. Patients with additional lesions were significantly more likely to have decreased index adenoma size as indicated either by preoperative imaging or by intraoperative findings (15.5 ± 6.6 vs. 8.3 ± 2.5 mm, p < 0.001). None of the patients with an adenoma size greater than 13 mm had an additional pathologic gland.

conclusionsOur findings suggest that the routine use of ioPTH in MIP candidates may be omitted in patients with an index adenoma greater than 13 mm, even with only a single positive preoperative imaging study, without compromising surgical success.

Indexed as

AdenomaHyperparathyroidism, PrimaryHumansMinimally Invasive Surgical ProceduresParathyroidectomyParathyroid HormoneRetrospective StudiesParathyroid Hormone

Identifiers

PMID35403873
OpenAlexW4223530563

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.