OUTCOME OF FOCUSED PARATHYROIDECTOMY WITH AND WITHOUT INTRA - OPERATIVE PTH ADJUNCT: COMPARATIVE STUDY BETWEEN TWO ACADEMIC MEDICAL CENTERS FARHEEN1234@GMAIL.COM

PW03-14

OUTCOME OF FOCUSED PARATHYROIDECTOMY WITH AND WITHOUT INTRA - OPERATIVE PTH ADJUNCT: COMPARATIVE STUDY BETWEEN TWO ACADEMIC MEDICAL CENTERS

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Sarojkanta Kanta Mishra SKMISHRA_1956@YAHOO.COM Endocrine Surgery Lucknow India *

India

Oral or Poster

The essentiality of intraoperative parathyroid hormone (IOPTH) monitoring in primary hyperparathyroidism (PHPT) patients with preoperative localized lesions is not well established. The aim of this study was to assess outcomes of patients undergoing focused parathyroidectomy with and without IOPTH monitoring in two high volume centers in India.

Retrospective study (1990-2020) consisting of patients undergoing focused parathyroidectomy (FP) in two tertiary referral centers one each in Northern and Southern India. Arm A (n=59)- FP in Northern center without IOPTH, Arm B- FP in Northern center with IOPTH (n=138), Arm C- (n=332)- FP in Southern center without IOPTH. All patients had preoperatively localized parathyroid adenoma with concordant finding on neck USG and MIBI scan. Patients with at least 6 months follow-up were included in the study. Cure and recurrence rate were compared between three groups.

Mean age was significantly low in Arm A (35 Vs 42 Vs 46 years; p=0.001). Preoperative highest serum calcium value (15.4 Vs 16.3 Vs1 7.7mg/dl; p=0.440). Median preoperative serum PTH concentration was significantly low in Arm C (547 Vs 429Vs 314 pg/dl; p=0.028). Histology report was adenoma in 95% patients (94.8 Vs 94.2 Vs 95.7%, p=0.186). Cure rate (96.9 Vs 98.6 Vs 95.8%; p=0.398), and recurrence rate didn’t differ significantly in three arms (1.7 Vs 0.7% Vs 0.9%; p=0.0).

PHPT patients with significantly different clinicopathological profile undergoing FP with or without IOPTH monitoring have comparable outcomes. IOPTH adjunct should be used in selective cases.