Acta endocrinologica (Bucharest, Romania : 2005) · 2025
COULD THE RATE OF DECREASE IN INTRAOPERATIVE PARATHYROID HORMONE LEVEL BE A DETERMINANT OF SURGICAL TECHNIQUE IN TERTIARY HYPERPARATHYROIDISM?
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Güzel G, Ünal D Sarıdemir, Özen A, Saçın Y E, Yılmaz N, Boz A, Arıcı C
Аннотация
CONTEXT: Intraoperative parathyroid hormone (IO PTH) monitoring has determinative role in surgery for tertiary hyperparathyroidism (tHPT).
OBJECTIVE: We tried to find out whether the extent of surgery to be performed can be dedicated via IO PTH monitoring in tHPT.
DESIGN: Renal transplantation (RTX) recipients who had been operated and followed up because of tHPT between 9/2014 and 5/2021 at our institution were retrospectively analysed.
SUBJECTS AND METHODS: We analysed the pre-operative and postoperative data of 41 patients with tHPT.
RESULTS: Considering IO PTH monitoring; 70% and more decrease of the hormone level leaded us favourable results (89% surgical success) regardless of the PTX method (p<0.05). We obtained the same surgical success rate (75%) in patients in whom monitoring was done and was not done. We observed high success ratios (100%) in the latter group via subtotal PTX and total PTX plus autotransplantation (AT) (p<0.05).
CONCLUSIONS: In surgery for tHPT, IO PTH monitoring should be maintained. When we observe 70% or more decline in the hormone level, we can decide to finish the operation regardless of the surgical technique. If hormone level decrease is below 70%, we have to continue exploration.
OBJECTIVE: We tried to find out whether the extent of surgery to be performed can be dedicated via IO PTH monitoring in tHPT.
DESIGN: Renal transplantation (RTX) recipients who had been operated and followed up because of tHPT between 9/2014 and 5/2021 at our institution were retrospectively analysed.
SUBJECTS AND METHODS: We analysed the pre-operative and postoperative data of 41 patients with tHPT.
RESULTS: Considering IO PTH monitoring; 70% and more decrease of the hormone level leaded us favourable results (89% surgical success) regardless of the PTX method (p<0.05). We obtained the same surgical success rate (75%) in patients in whom monitoring was done and was not done. We observed high success ratios (100%) in the latter group via subtotal PTX and total PTX plus autotransplantation (AT) (p<0.05).
CONCLUSIONS: In surgery for tHPT, IO PTH monitoring should be maintained. When we observe 70% or more decline in the hormone level, we can decide to finish the operation regardless of the surgical technique. If hormone level decrease is below 70%, we have to continue exploration.