ArticleFrontiers in endocrinology2024
Is intraoperative parathyroid monitoring during minimally invasive parathyroidectomy still justified?
Article in Frontiers in endocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Comparative analysis of PTH Washout and 99mTc-MIBI SPECT/CT in presurgical localization for patients with primary hyperparathyroidism.Journal of endocrinological investigation · 2026Article
- Challenges and unmet needs of [European journal of nuclear medicine and molecular imaging · 2026Article
- Hyperparathyroidism: historical milestones and modern therapeutic strategies.Wiener klinische Wochenschrift · 2026Review
- Primary hyperparathyroidism: targeted, focused exploration with "selective" parathyroidectomy : Minimally invasive open vs. minimally invasive video-assisted vs. endoscopic approach.Wiener klinische Wochenschrift · 2026Review
- Do stricter criteria for intraoperative parathyroid hormone monitoring reduce the risk of persistence or reoperation in primary hyperparathyroidism? A receiver operating characteristic analysis.Langenbeck's archives of surgery · 2025Article
- Preoperative phosphorus levels may serve as a predictor of recurrent/persistent lesions after surgery for primary hyperparathyroidism: a cross-sectional study.Gland surgery · 2025Article
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Abstract
Introduction: Primary hyperparathyroidism (PHPT) is the third most common endocrine disease. With parathyroidectomy, a cure rate of over 95% at initial surgery is reported. Localization of the abnormal parathyroid gland is critical for the operation to be successful. The aim of this study is to analyze data of patients with single gland disease (SGD) and positive concordant localization imaging undergoing minimally invasive parathyroidectomy (MIP) and intraoperative parathyroid hormone monitoring (IOPTH) to evaluate if IOPTH is still justified in patients with localized SGD. Methods: A retrospective database analysis of all minimally invasive operations with IOPTH for PHPT and positive concordant localization in ultrasound (US) and Results: In total, 198 patients were included in the study. The sensitivity of US, MIBI and PET-CT was 96%, 94% and 100%, respectively. Positive predictive value was 88%, 89% and 94% with US, MIBI and PET-CT, respectively. IOPTH was true positive in 185 (93.4%) patients. In 13 (6.6%) patients, no adequate IOPTH decline was observed after localizing and extirpating the assumed enlarged parathyroid gland. Without IOPTH, the cure rate decreased from 195 (98.5%) to 182 (92%) patients and the rate of persisting disease increased from 2 (1.0%) to 15 (7.5%) patients. Conclusion: Discontinuing IOPTH significantly increases the persistence rate by a factor of 7.5 in patients with concordantly localized adenoma. Therefore, IOPTH appears to remain necessary even for this group of patients.
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