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

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.

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Publication Details

Journal
Updates in Surgery
Published
2025-10-22
DOI
https://doi.org/10.1007/s13304-025-02430-8
Citations
1
Primary Topic
Parathyroid Disorders and Treatments
Type
article
Field-Weighted Citation Impact
1.43

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

Francesco Pedicini, Paolo Del Rio, Alessandra Micalizzi, Anna Borrelli et al.
1 citations
Updates in Surgery
Parathyroid Disorders and Treatments
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article

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

Francesco Pedicini, Paolo Del Rio, Alessandra Micalizzi, Anna Borrelli, Alessandro Giordano, Gianlorenzo Dionigi, Michele Minuto, Francesco Quaglino, Luca Cestino, Angela Pezzolla, Antonella Tudisco, Giulia Canu, Marco Raffaelli, L Giangreco, E Raggio, Antonio Toniato, Luca Sessa, Nadia Innaro, E. Brugger, Marco Moretti, Tommaso Loderer, D. Schiavone, Livia Palmieri, C. Talarico, Rebecca Panconesi, Teresa Perra, N Palestini, Stefano Spiezia, Maurizio Iacobone, G. Montecamozzo, Massimiliano Veroux, Piermarco Papini, Cara Bergamo, Gianfranco D’Onghia, Anthony A. Gatti, Luigi Oragano, Eleonora Lori, Francesco D’Angelo, Alberto Porcu, Fabio Civitillo, Barbara Mullineris, Francesco Feroci, I. N. Tiraboschi, Roberto Filippi, Gianluca Donatini, Damiano Chiari, Chiara Dobrinja, Mario Testini, Giuseppa Graceffa, Raèf Mina, Valeria Matteucci, Giovanna Pavone, A. Pasculli, Enrico Battistella, Serena Elisa Tempera, Daniele Pironi, Emanuela Traini, Mario Pacilli, Giovanni Docimo, Roberto G. Lucchini, Domenico Tripodi, Fatima Domenica Elisa De Palma, Nicola Tartaglia, Gabriele Ricci, Alan Attard, Rossella Melcarne, Loredana De Pasquale, A Antonino, Luca Rosato, Maria Paola Belfiore, Pier Francesco Alesina, Alessandro Garbellini, Maria Luisa Altana, Aldo Bove, Salvatore Sorrenti, Maurizio Bossotti, Marco Boniardi, Marco Bononi, Umile Giuseppe Longo, Fabio Medas, Leonardo Rossi, Alessandra Di Lascia, Gabriele Materazzi, Carmela De Crea, Grégorio Scerrino, Valerio D’Orazi, Andrea Borasi, Pietro Giorgio Calò, Malince Chicas Vasquez, A. Gurrado, Mariarosa Pelizzo, Simona Beretta, P. Capelli, G. Giraudo, Gianluca Ansaldo
article en
1 citations

Abstract

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.

Updates in SurgeryVol. 78(1)
Università Cattolica del Sacro Cuore (IT), University of Parma (IT), University of Padua (IT), University of Cagliari (IT), University of Campania "Luigi Vanvitelli" (IT), Agostino Gemelli University Polyclinic (IT), Fatebenefratelli Hospital (IT), Azienda Ospedaliera Universitaria Pisana (IT), University of Bari Aldo Moro (IT), Sapienza University of Rome (IT)
Università degli Studi di Milano, Università degli Studi di Cagliari, Università degli Studi di Padova, Sapienza Università di Roma, Università degli Studi di Firenze, Università degli Studi di Genova, Università degli Studi di Parma, Università degli Studi di Palermo, Universita degli Studi di Bari Aldo Moro, Università degli Studi di Sassari, Università degli Studi di Torino, Università di Pisa, Universität Duisburg-Essen, Istituto Oncologico Veneto, Humanitas University, Università degli Studi di Perugia, Université de Poitiers
Openalex Percentile: Top 15%
Parathyroid Disorders and Treatments
1.43
DOIOpen Access PDFOpenAlex
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