Correlation of Solitary Parathyroid Adenoma Weight With the Intraoperative Parathyroid Hormone Decline Rate During Parathyroidectomy

Purpose: In primary hyperparathyroidism (PH), surgeons need to be sure intraoperatively that they have removed the entire pathological parathyroid tissue for a successful procedure. This study aims to investigate if the weight of the excised parathyroid adenoma is correlated with the decline rate of intraoperative parathyroid hormone levels (ioPTH) after excision. Methods: The data of 212 patients (174 women and 38 men) who underwent an operation for solitary parathyroid adenoma from January 2018 to October 2021 were retrospectively analysed. In all patients, a blood sample for parathyroid hormone (PTH) level measurement was obtained after anaesthesia induction and 10 and 20 minutes after adenoma removal. In the statistical analysis, the parameters related to the weight of the adenoma and the reported PTH values were studied. Results: Analysis revealed a statistically significant positive correlation (P<0.05) between the adenoma weight and the percentage of ioPTH fall at 10 and 20 minutes after resection, although with a small coefficient (r=0.191 in 10 minutes and r=0.208 in 20 minutes). Conclusion: Our data analysis reveals a positive correlation between adenoma weight and the percentage of ioPTH decline 10 and 20 minutes after parathyroidectomy. While the literature review supports this correlation, more data is still needed to be used as a surgical tool. This includes parameters such as postoperative follow-up and the histological examination of the adenomas, underscoring the importance of ongoing research in this field.