title: Focused parathyroidectomy without intra-operative parathyroid hormone monitoring for primary hyperparathyroidism: results in a low-volume hospital.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery,United Christian Hospital,Kowloon,Hong Kong SAR.
authors.forename: T-L
authors.initials: TL
authors.lastname: Chow
authors.affiliation: Department of Surgery,United Christian Hospital,Kowloon,Hong Kong SAR.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Choi
authors.affiliation: Department of Surgery,United Christian Hospital,Kowloon,Hong Kong SAR.
authors.forename: S-H
authors.initials: SH
authors.lastname: Lam
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000772:Anesthesia, Local; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D061846:Hospitals, Low-Volume; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000601:surgery*; D006996:Hypocalcemia / Q000097:blood; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000097:blood* / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011183:Postoperative Complications / Q000097:blood; D012189:Retrospective Studies
chemical_list: D010281:Parathyroid Hormone
keywords: Intraoperative Monitoring; Outcome Study; Parathyroid Hormone; Parathyroidectomy; Primary Hyperparathyroidism