Abstract
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.