{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:48:05Z","timestamp":1792759685100,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intraoperative PTH (ioPTH) monitoring has become widely accepted in the era of minimally invasive parathyroidectomy (MIP). The purpose of this study was to evaluate the need for ioPTH during parathyroidectomy in patients with positive preoperative imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The charts of patients who underwent parathyroidectomy at three tertiary centers between the years 2012 and 2021 were retrospectively reviewed. Patients were defined as MIP candidates with either concordant preoperative imaging or a single positive imaging. Patients with negative or discordant imaging, concomitant thyroidectomy, or previous neck surgery were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of a total of 1013 patients who underwent parathyroidectomy, 535 (52.8%) were defined as MIP candidates and were included in the statistical analysis. Surgical success was achieved in all patients. A single adenoma that corresponded to the preoperative imaging was identified and resected in 517 (93.8%) patients. In only 18 (3.3%) patients, the ioPTH correctly changed the operative management where additional pathologic glands were identified and excised. Patients with additional lesions were significantly more likely to have decreased index adenoma size as indicated either by preoperative imaging or by intraoperative findings (15.5\u2009\u00b1\u20096.6 vs. 8.3\u2009\u00b1\u20092.5\u00a0mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). None of the patients with an adenoma size greater than 13\u00a0mm had an additional pathologic gland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that the routine use of ioPTH in MIP candidates may be omitted in patients with an index adenoma greater than 13\u00a0mm, even with only a single positive preoperative imaging study, without compromising surgical success.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06537-6","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T13:08:48Z","timestamp":1649682528000},"page":"1908-1914","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Minimally Invasive Parathyroidectomy: Can Intraoperative Parathyroid Hormone Monitoring be Omitted?"],"prefix":"10.1002","volume":"46","author":[{"given":"Shalom","family":"Eligal","sequence":"first","affiliation":[{"name":"Hadassah Hebrew\u2010University School of Medicine Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Mekel","sequence":"additional","affiliation":[{"name":"Department of Surgery Rambam\u2010Health Care Campus Haifa Israel"},{"name":"Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Hadassah Hebrew\u2010University School of Medicine Jerusalem Israel"},{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Hadassah Ein\u2010Kerem, Hebrew\u2010University Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariya","family":"Neymark","sequence":"additional","affiliation":[{"name":"Department of Surgery Rambam\u2010Health Care Campus Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Hirshoren","sequence":"additional","affiliation":[{"name":"Hadassah Hebrew\u2010University School of Medicine Jerusalem Israel"},{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Hadassah Ein\u2010Kerem, Hebrew\u2010University Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Mizrahi","sequence":"additional","affiliation":[{"name":"Hadassah Hebrew\u2010University School of Medicine Jerusalem Israel"},{"name":"Department of Surgery, Faculty of Medicine Hadassah\u2010Hebrew University Medical Center, Mount Scopus Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Eliashar","sequence":"additional","affiliation":[{"name":"Hadassah Hebrew\u2010University School of Medicine Jerusalem Israel"},{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Hadassah Ein\u2010Kerem, Hebrew\u2010University Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haggi","family":"Mazeh","sequence":"additional","affiliation":[{"name":"Hadassah Hebrew\u2010University School of Medicine Jerusalem Israel"},{"name":"Department of Surgery, Faculty of Medicine Hadassah\u2010Hebrew University Medical Center, Mount Scopus Jerusalem 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