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Surgeons request intraoperative parathyroid hormone (PTH) monitoring during parathyroidectomy procedures to confirm identification of abnormal gland tissue. Generally, a 50% decrease in the baseline PTH level indicates the abnormal tissue has been removed. A delay in collecting and processing PTH blood samples can complicate intraoperative decision making and prolong the procedure. The purpose of this quality improvement project was to develop tools to facilitate the specimen management process (eg, requesting, transporting, analyzing) for PTH blood samples and decrease the average total time required for transit and assay. We implemented a two-pronged initiative that involved improving the laboratory requisition form and creating a parathyroid tote box to contain all the needed information and supplies. The average total time for transit and assay decreased from 31.36 minutes before implementation to 22.06 minutes after implementation. Perioperative nurses expressed satisfaction with the changes and continue to use the revised process.
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http://dx.doi.org/10.1002/aorn.14162 | DOI Listing |
J Pediatr Surg
September 2025
Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland; Department of Pediatric and Adolescent Endocrinology, University Children's Hospital of Krakow, Krakow, Poland.
Background: The primary goals of surgical management in thyroid disorders are the treatment of malignancy, goiter, and thyrotoxicosis, while adhering to the principle of 'primum non nocere'. Hypocalcemia is among the most common complications, primarily resulting from inadvertent injury to the parathyroid glands.
Methods: A retrospective analysis of 2015-2023 records of Polish pediatric patients who underwent thyroid surgery.
JAMA Surg
September 2025
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Importance: The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a scarless surgical technique gaining popularity; however, its safety, cost, and impact on pathological evaluation compared with minimally invasive nonendoscopic thyroidectomy (MINET) remain under evaluation.
Objective: To compare surgical outcomes, pathological considerations, and cost profiles following TOETVA vs MINET using a propensity-matched cohort.
Design, Setting, And Participants: This cohort study included 720 patients undergoing oncoplastic thyroidectomy between January 2021 and January 2023, with 12-month follow-up, at a tertiary referral center in Taipei, Taiwan.
Background The accurate preoperative localization of parathyroid adenomas is crucial for minimally invasive parathyroidectomy (MIP) in primary hyperparathyroidism (PHPT). This study assessed the diagnostic performance of four-dimensional computed tomography (4D CT) in detecting parathyroid adenomas, compared with ultrasound (USG) and technetium methoxy isobutyl isonitrile single photon emission computed tomography (99mTc-sestamibi SPECT/CT). Methods We retrospectively analyzed 53 patients with biochemically confirmed PHPT who underwent all three preoperative imaging modalities, followed by parathyroidectomy from January 2020 to January 2025.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
August 2025
From the Department of Neuroradiology (S.A, H.A.Q., J.M.D., A.M., H.A.S., M.W., T.H.) and Department of Head and Neck Pathology (M.D.W.), The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Parathyroid lipoadenoma (PLA) is a rare cause of primary hyperparathyroidism and is over 50% adipose tissue, which complicates preoperative localization. We aimed to describe clinical and imaging features of PLA in this case series. We retrospectively reviewed 4 patients with pathologically confirmed PLA and biochemical evidence of primary hyperparathyroidism.
View Article and Find Full Text PDFJ Pediatr Surg
August 2025
Pediatric Surgery and Urology Division, Hospital Italiano, Buenos Aires, Argentina.
Objective: Secondary and tertiary hyperparathyroidism in children with chronic kidney disease (CKD) require complex management. Surgical intervention aims to reduce parathyroid hormone (PTH) levels in CKD patients, thereby preventing complications associated with hyperparathyroidism (HPT). We describe our 13-year experience in the surgical management of secondary and tertiary hyperparathyroidism in pediatric patients, including total or subtotal parathyroidectomy, autoimplantation, cryopreservation, and deferred autoimplantation.
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