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Focused parathyroidectomy without intra-operative parathyroid hormone monitoring for primary hyperparathyroidism: results in a low-volume hospital

Published online by Cambridge University Press:  15 June 2015

T-L Chow ,
C-Y Choi  and
S-H Lam
T-L Chow*
Affiliation:
Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR
C-Y Choi
Affiliation:
Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR
S-H Lam
Affiliation:
Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR
*
Address for correspondence: Dr T-L Chow, Department of Surgery, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong SAR Fax: 852 3513 5619 E-mail: tamlinc@yahoo.com
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Abstract

Background:

The role of routine intra-operative parathyroid hormone monitoring for sporadic primary hyperparathyroidism is contentious. Satisfactory results can be achieved in high-volume centres. The results of low-volume hospitals are rarely studied.

Methods:

A retrospective, non-comparative study was conducted. From November 2002 to October 2012, 105 patients with clinically sporadic primary hyperparathyroidism underwent focused parathyroidectomy without intra-operative parathyroid hormone monitoring. Single adenoma was localised on pre-operative ultrasonography or sestamibi scan. The cure rate, surgical complication rate and pathology findings were evaluated.

Results:

Most of the operations (63.8 per cent) were performed under local anaesthesia. All but two patients (98.1 per cent) were cured after surgery. There was only one case of double adenomas. No recurrent hyperparathyroidism was observed after a mean follow up of 56.9 months. Surgical complications comprised two cases (1.9 per cent) of transient vocal fold palsy and one case (1.0 per cent) of permanent vocal fold palsy. Seven patients (6.7 per cent) suffered temporary hypocalcaemia.

Conclusion:

Satisfactory results of focused parathyroidectomy without routine intra-operative parathyroid hormone monitoring for appropriately selected primary hyperparathyroidism cases can be attained in a low-volume hospital.

Keywords

Intraoperative MonitoringParathyroid HormonePrimary HyperparathyroidismParathyroidectomyOutcome Study
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 8 , August 2015 , pp. 788 - 794
Copyright
Copyright © JLO (1984) Limited 2015 

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