PDF(Pubmed)
Abstract：
Hyperparathyroidism is a common endocrine disorder that occurs secondary to abnormal parathyroid gland functioning. Depending on the type of hyperparathyroidism, surgical extirpation of hyperfunctioning parathyroid glands can be considered for disease cure. Intraoperative parathyroid hormone (IOPTH) monitoring improves outcomes in patients undergoing surgery for primary hyperparathyroidism, but studies are needed to characterize its institutional adoption and its role in surgery for secondary and tertiary hyperparathyroidism, as these entities can be difficult to cure. Hence, we will perform a cross-sectional survey study of surgeon rationale, operational details, and barriers associated with IOPTH monitoring adoption across North America. We will utilize a convenience sampling technique to distribute an online survey to head and neck surgeons and endocrine surgeons across North America. This survey will be distributed via email to three North American professional societies (i.e., Canadian Society for Otolaryngologists-Head and Neck Surgeons, American Head and Neck Society, and American Association of Endocrine Surgeons). The survey will consist of 30 multiple choice questions that are divided into three concepts: (1) participant demographics and training details, (2) details of surgical adjuncts during parathyroidectomy, and (3) barriers to adoption of IOPTH. Descriptive analyses and multiple logistic regression will be used to evaluate the impact of demographic, institutional, and training variables on the use of IOPTH monitoring in surgery for all types of hyperparathyroidism and barriers to IOPTH monitoring adoption. Ethics approval was obtained by the Hamilton Integrated Research Ethics Board (2024-17173-GRA). These findings will characterize surgeon and institutional practices with regards to IOPTH monitoring during parathyroid surgery and will inform future trials aimed to optimize the use of IOPTH monitoring in secondary and tertiary hyperparathyroidism.
摘要：
甲状旁腺功能亢进是一种常见的内分泌疾病，继发于甲状旁腺功能异常。根据甲状旁腺功能亢进的类型,手术切除功能亢进的甲状旁腺可考虑治愈疾病。术中甲状旁腺激素（IOPTH）监测可改善原发性甲状旁腺功能亢进手术患者的预后，但是需要研究来描述其在机构上的采用及其在继发性和三级甲状旁腺功能亢进症手术中的作用，因为这些实体很难治愈。因此，我们将对外科医生的基本原理进行横断面调查研究，操作细节，以及与北美IOPTH监测采用相关的障碍。我们将利用便利的采样技术向北美的头颈部外科医生和内分泌外科医生分发在线调查。这项调查将通过电子邮件分发给三个北美专业协会(即，加拿大耳鼻喉科医师协会-头颈外科医生，美国头颈协会，和美国内分泌外科医师协会)。调查将由30个多项选择题组成，分为三个概念：（1）参与者人口统计和培训细节，（2）甲状旁腺切除术期间的手术附件的细节，(3)采用IOPTH的障碍。描述性分析和多元逻辑回归将用于评估人口统计学的影响，机构,以及在所有类型的甲状旁腺功能亢进症手术中使用IOPTH监测的培训变量，以及IOPTH监测采用的障碍。汉密尔顿综合研究伦理委员会（2024-17173-GRA）获得了伦理批准。这些发现将描述外科医生和机构在甲状旁腺手术期间IOPTH监测方面的实践，并将为未来旨在优化IOPTH监测在继发性和三级甲状旁腺功能亢进症中的使用的试验提供信息。
