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. 2022 Oct 16;58(10):1464.
doi: 10.3390/medicina58101464.

Single-Center Experience of Parathyroidectomy Using Intraoperative Parathyroid Hormone Monitoring

Seong Hoon Kim  1 , Si Yeon Lee  1 , Eun Ah Min  1 , Young Mi Hwang  1 , Yun Suk Choi  1 , Jin Wook Yi  1
Affiliations

Single-Center Experience of Parathyroidectomy Using Intraoperative Parathyroid Hormone Monitoring

Seong Hoon Kim et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Hyperparathyroidism (HPT) is a rare endocrine disease associated with the elevated metabolism of calcium, vitamin D, and phosphate by the hyperfunctioning of the parathyroid glands. Here, we report our experience of parathyroidectomy using intraoperative parathyroid hormone (IOPTH) monitoring in a single tertiary hospital. Materials and Methods: From October 2018 to January 2022, a total of 47 patients underwent parathyroidectomy for HPT. We classified the patients into two groups-primary HPT (PHPT, n = 37) and renal HPT (RHPT, n = 10)-and then reviewed the patients' data, including their general characteristics, laboratory results, and perioperative complications. Results: Thirty-five of the thirty-seven patients in the PHPT group underwent focused parathyroidectomy, while all ten patients in the RHPT group underwent subtotal parathyroidectomy. IOPTH monitoring based on the Milan criteria was used in all cases. Preoperative and 2-week, 6-month, and 12-month postoperative parathyroid hormone (PTH) levels were within the normal range in the PHPT group, whereas they were higher than normal in the RHPT group. Transient hypocalcemia occurred only in the RHPT group, with calcium levels returning to normal levels 12 months after surgery. Conclusions: Parathyroidectomy with IOPTH monitoring in our hospital showed favorable clinical outcomes. However, owing to the small number of patients due to the low frequency of parathyroid disease, long-term, prospective studies are needed in the future.

Keywords: hyperparathyroidism; intraoperative parathyroid hormone; parathyroid hormone.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
IOPTH assay according to primary hyperparathyroidism (PHPT) and renal (secondary and tertiary) hyperparathyroidism (RHPT).
Figure 2
Figure 2
Laboratory results change before and after parathyroidectomy according to primary hyperparathyroidism (PHPT) and renal (secondary and tertiary) hyperparathyroidism (RHPT). ((A) PTH. (B) Calcium. (C) Ionized Calcium. (D) Phosphate).
Figure 2
Figure 2
Laboratory results change before and after parathyroidectomy according to primary hyperparathyroidism (PHPT) and renal (secondary and tertiary) hyperparathyroidism (RHPT). ((A) PTH. (B) Calcium. (C) Ionized Calcium. (D) Phosphate).
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