Application of Tider process in parathyroidectomy for treatment of secondary hyperparathyroidism

Objective To optimize the operative process of parathyroidectomy (PTX) for the treatment of secondary hyperparathyroidism (SHPT). Methods Four approaches including tracing/imaging, dissection, exploration, and resection were integrated into Tider process. Nano-carbon particles were used to inject into thyroid glands for imaging and separation of cervical tissue was performed with specific vision of anatomic landmarks. Parathyroid glands were thoroughly revealed by standard exploration using inspection and palpation. Resection of parathyroids should involve the surrounding tissue as more as possible. This Tider process was used into PTX for 25 patients with SHPT in Tider group since March 2018. Thirty-four patients with SHPT without use of Tider process were in control group from March 2015 to December 2018. Outcomes including operative time, operative success rate and PTH at the postoperative first day were compared between Tider group and control group. Results Total PTX and total PTX with auto-transplantati