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European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 1/2019

01-01-2019 | Short Communication

Intraoperative parathyroid hormone testing in primary hyperparathyroidism surgery: time for giving up?

Authors: Paola Vincenza Sartori, Alberto Maria Saibene, Ennio Leopaldi, Marco Boniardi, Edoardo Beretta, Samuele Colombo, Emanuela Morenghi, Juliana Pauna, Loredana De Pasquale

Published in: European Archives of Oto-Rhino-Laryngology | Issue 1/2019

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Abstract

Purpose

Intraoperative PTH testing (IOPTH) in treatment of primary hyperparathyroidism (PH) is debated. Some authors advise against IOPTH in patients with concordant preoperative imaging undergoing focused parathyroidectomy. This study aims to compare focused parathyroidectomy success rates with and without IOPTH in patients with concordant preoperative imaging.

Methods

Retrospective cohort study involving 599 consecutive patients underwent surgery for PH from 2012 to 2017. Patients with discordant preoperative imaging were excluded. 426 patients underwent focused parathyroidectomy (214 patients without IOPTH and 212 with IOPTH) and were considered for the statistical analysis. In case of insufficient IOPTH decay (less than 50%), a bilateral exploration was carried out.

Results

The IOPTH group and the non-IOPTH group were similar for demographics and preoperative PTH and calcaemia. 413 patients were cured and disease persistence rates between groups were not significantly different (p > 0.05).

Conclusions

Although further testing and randomized-controlled trials are required to validate our findings, our data show that IOPTH does not seem to improve the outcome in patients with concordant preoperative imaging undergoing focused parathyroidectomy.
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Metadata
Title
Intraoperative parathyroid hormone testing in primary hyperparathyroidism surgery: time for giving up?
Authors
Paola Vincenza Sartori
Alberto Maria Saibene
Ennio Leopaldi
Marco Boniardi
Edoardo Beretta
Samuele Colombo
Emanuela Morenghi
Juliana Pauna
Loredana De Pasquale
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 1/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5179-x

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