Intra-operative parathyroid hormone evaluation is superior to frozen section analysis in parathyroid surgery

Aksoy, Süleyman Özkan; Adiyaman, Suleyman Cem; Cevlik, A.D.; Durak, Merih Güray; Seçil, Mustafa; Sevinç, Ali İbrahim

doi:10.1016/j.amjoto.2020.102886

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…However, none of them have managed to minimize persistent HPT rates. The effect of ioPTH reduction rate on appropriate surgery decisions and the many factors affecting this rate have been discussed [11][12][13][14][15][16] . In our opinion, if the success rates of PTx can be increased by using an algorithm or certain criteria, it would be possible to reduce both reoperations and complications.…”

Section: Discussionmentioning

confidence: 99%

“…In many studies examining the relationship between adenoma volume and weight and biochemical parameters, such as PTH, calcium, and phosphorus, the information in pathology reports for adenoma volume and weight was used retrospectively and was calculated according to the dimensions in the volume pathology reports 1,4,6,7,12 .…”

Section: Discussionmentioning

confidence: 99%

“…In our literature review (PubMed), we found only a few articles investigating the relationship between ioPTH drop rate and adenoma volume and weight 7,18,19 . Most of the articles sought answers to questions, such as how many minutes should ioPTH be run after excision, what the PTH drop rate should be, or how to calculate the drop rate based on the preop highest PTH value or PTH viewed before starting surgery [11][12][13][14][15][16] . Ours was the first prospective study to investigate the relationship between ioPTH drop rate and adenoma volume and weight in PHPT cases.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Correlation of Intraoperative Parathyroid Hormone Levels of Primary Hyperparathyroidism with Single Adenoma Volume and Weight: Can Optimal Criteria be Created to End The Surgery?

Tarim¹,

Akgün²,

Derebey³

et al. 2021

Cumhuriyet Medical Journal

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To study the relationship of intraoperative parathormone (PTH) decrease levels with solitary parathyroid adenoma (SPA) weight, diameter, and volume of the adenoma in patients with primary hyperparathyroidism (PHPT). Method: Prospectively evaluation of consecutive patients undergoing parathyroidectomy (PTx) with the diagnosis of PHPT related to SPA. Perioperative biochemical parameters of patients; volume, weight and diameters of adenoma were recorded. Intraoperative PTH drop percentages were calculated. Adenoma diameter and volume were measured and calculated using preoperativ ultrasound. Adenoma was weighed intraoperatively by the surgeon. Results: Forty-five consecutive patients underwent PTx for a SPA between October 2018 and October 2019. There were 9 men and 36 women, with a mean age of 51 ± 14.94 years. A positive correlation was identified between the volume with the weight and maximum diameter of resected parathyroid glands (r = 0.613, p< 0.001; r = 0.871, p< 0.001, respectively). There was a positive correlation between volume and preoperative PTH levels, albeit a weak one (r = 0.334, p = 0.025). No significant relationship was found between adenoma volume and ioPTH drop rate (r = 0.088, p = 0.565). Conclusions: We have not been able to establish criteria based on correlation between PA volume and weight and the ioPTH drop rate that would allow us to make decisions on ending the parathyroidectomy and reducing persistent PHPT cases.

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