Parathyroidectomy outcomes according to operative approach

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Parathyroidectomy for primary sporadic hyperparathyroidism (psHPT) has advanced with improved localization and intraoperative parathyroid hormone (ioPTH) monitoring.
• These advancements have facilitated the adoption of minimally invasive parathyroidectomy (MIPS) approaches.

Purpose of the Study:

• To compare the outcomes of different parathyroidectomy techniques for psHPT.
• To evaluate the efficacy and efficiency of MIPS with ioPTH monitoring.

Main Methods:

• A retrospective study of 220 patients undergoing parathyroidectomy for psHPT.
• Patients were divided into three groups: bilateral neck exploration (BNE), BNE with ioPTH monitoring, and MIPS with ioPTH monitoring.
• Outcomes including serum calcium, intact parathyroid hormone (PTH) levels, operative time, and patient charges were analyzed.

Main Results:

• All techniques demonstrated high eucalcemia rates (99-100%) and similar rates of persistent disease and recurrence.
• MIPS with ioPTH monitoring resulted in shorter operative times compared to BNE with ioPTH monitoring.
• Frozen sections and patient charges were significantly lower in the MIPS group.

Conclusions:

• Parathyroidectomy for psHPT is highly successful using current techniques.
• MIPS with ioPTH monitoring is a potentially quicker and more cost-effective approach for psHPT when feasible.