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<p>Primary hyperparathyroidism (PHPT) is a frequent endocrine disorder, with surgery as the only curative option. Despite evolving guidelines, real-life management remains variable across centers. A national survey was conducted among members of the Italian Society of Endocrine Surgery (SIUEC) to evaluate current practices in PHPT surgery, including the use of minimally invasive approaches and intraoperative parathyroid hormone (ioPTH) monitoring. Eighty-eight endocrine surgeons participated. Minimally invasive parathyroidectomy was the preferred approach, especially among high-volume surgeons. ioPTH was used by 83% of respondents, although its necessity in cases with concordant imaging was debated. Cervical ultrasound and <sup>99m</sup>Tc-sestamibi were routinely used for localization; choline PET/CT was employed selectively. Significant differences emerged between low- and high-volume surgeons in surgical technique, ioPTH timing, and use of neuromonitoring. The survey highlights heterogeneity in the management of PHPT in Italy, suggesting room for standardization and broader guideline adherence. Efforts are needed to promote uniform, evidence-based practices nationwide.</p>

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Parathyroidectomy and the use of ioPTH. A survey of the United Italian Society of Endocrine Surgery (SIUEC)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月22日

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  • Paolo Del Rio,
  • Salvatore Sorrenti,
  • Giovanni Docimo,
  • Gabriele Materazzi,
  • Mario Testini,
  • Pietro Giorgio Calò,
  • Marco Raffaelli,
  • Maurizio Iacobone,
  • Carmela De Crea,
  • Eleonora Lori,
  • Elena Bonati,
  • P. Alesina,
  • M. L. Altana,
  • G. Ansaldo,
  • A. Antonino,
  • A. Attard,
  • E. Battistella,
  • M. Belfiore,
  • S. Beretta,
  • C. Bergamo,
  • M. Boniardi,
  • M. Bononi,
  • A. Borasi,
  • A. Borrelli,
  • M. Bossotti,
  • A. Bove,
  • E. Brugger,
  • G.L. Canu,
  • P. Capelli,
  • L. Cestino,
  • D. Chiari,
  • M. Chicas Vasquez,
  • F. Civitillo,
  • F. D’Angelo,
  • G. D’Onghia,
  • V. D’Orazi,
  • R. De Filippi,
  • L. De Pasquale,
  • A. Di Lascia,
  • G. Dionigi,
  • C. Dobrinja,
  • G. Donatini,
  • F. Feroci,
  • A. Garbellini,
  • A. Gatti,
  • L. Giangreco,
  • A. Giordano,
  • G. Giraudo,
  • G. Graceffa,
  • A. Gurrado,
  • N. Innaro,
  • T. Loderer,
  • G. Longo,
  • R. Lucchini,
  • V. Matteucci,
  • F. Medas,
  • R. Melcarne,
  • A. Micalizzi,
  • R. Minà,
  • M. Minuto,
  • G. Montecamozzo,
  • M. Moretti,
  • B. Mullineris,
  • L. Oragano,
  • M. Pacilli,
  • N. Palestini,
  • F. Palma,
  • L. Palmieri,
  • R. Panconesi,
  • P. Papini,
  • A. Pasculli,
  • G. Pavone,
  • F. Pedicini,
  • M. Pelizzo,
  • T. Perra,
  • A. Pezzolla,
  • D. Pironi,
  • A. Porcu,
  • F. Quaglino,
  • E. Raggio,
  • G. Ricci,
  • L. Rosato,
  • L. Rossi,
  • G. Scerrino,
  • D. Schiavone,
  • L. Sessa,
  • S. Spiezia,
  • C. Talarico,
  • N. Tartaglia,
  • S. Tempera,
  • I. Tiraboschi,
  • A. Toniato,
  • E. Traini,
  • D. Tripodi,
  • A. Tudisco,
  • M. Veroux

摘要

Primary hyperparathyroidism (PHPT) is a frequent endocrine disorder, with surgery as the only curative option. Despite evolving guidelines, real-life management remains variable across centers. A national survey was conducted among members of the Italian Society of Endocrine Surgery (SIUEC) to evaluate current practices in PHPT surgery, including the use of minimally invasive approaches and intraoperative parathyroid hormone (ioPTH) monitoring. Eighty-eight endocrine surgeons participated. Minimally invasive parathyroidectomy was the preferred approach, especially among high-volume surgeons. ioPTH was used by 83% of respondents, although its necessity in cases with concordant imaging was debated. Cervical ultrasound and 99mTc-sestamibi were routinely used for localization; choline PET/CT was employed selectively. Significant differences emerged between low- and high-volume surgeons in surgical technique, ioPTH timing, and use of neuromonitoring. The survey highlights heterogeneity in the management of PHPT in Italy, suggesting room for standardization and broader guideline adherence. Efforts are needed to promote uniform, evidence-based practices nationwide.