title: Outcomes analysis of intraoperative adjuncts during minimally invasive parathyroidectomy for primary hyperparathyroidism.
abstract: BACKGROUND
  The aim of this study was to determine whether minimally invasive radioguided parathyroidectomy (MIRP) and intraoperative parathyroid hormone-guided parathyroidectomy (ioPTH) have equivalent intermediate-term outcomes in primary hyperparathyroidism (PHPT).
  
  
  METHODS
  A retrospective study of 244 patients who underwent parathyroidectomy for PHPT in a 25-month time period was conducted. Patients who either underwent MIRP- or ioPTH-guided parathyroidectomies were included. The primary outcome was persistent disease. Conversion to bilateral exploration, complications, and multigland disease (MGD) were secondary outcomes.
  
  
  RESULTS
  There was 1 MIRP patient and no ioPTH patients who had persistent disease. The ioPTH group had more conversions to a bilateral exploration (bilateral neck exploration [BNE]) (3.7% vs 13%, P = .024). In the MIRP group, no patients were found to have MGD. In the ioPTH group, 7 patients with double adenomas and 6 patients with MGD were found (0 vs 13, P = .0028).
  
  
  CONCLUSIONS
  ioPTH facilitates successful minimally invasive parathyroidectomy (MIP) when compared with MIRP and provides cure rates similar to BNE.
authors.affiliation: Department of Surgery, William Beaumont Hospital, Royal Oak, MI, USA. Sapna.Nagar@beaumont.edu
authors.forename: Sapna
authors.initials: S
authors.lastname: Nagar
authors.forename: Daryl
authors.initials: D
authors.lastname: Reid
authors.forename: Peter
authors.initials: P
authors.lastname: Czako
authors.forename: Graham
authors.initials: G
authors.lastname: Long
authors.forename: Charles
authors.initials: C
authors.lastname: Shanley
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010281:Parathyroid Hormone; D016105:Parathyroidectomy / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi