Abstract
Background
The success of minimally invasive parathyroidectomy is attributed to evolving preoperative
imaging techniques and intraoperative parathyroid hormone (IOPTH) measurement. The
additional value of IOPTH measurement in patients undergoing surgery for primary hyperparathyroidism
(pHPT) was evaluated.
Methods
Between 1999 and 2010 there were 119 patients who underwent surgery for pHPT at our
institutions. In all patients, preoperative imaging was performed and IOPTH samples
were collected prospectively but the results were not disclosed during surgery.
Results
Postoperative calcium level normalized in 114 patients (96%). The 5 surgical failures
represented the maximum yield of IOPTH sampling. Three of these patients would have
been identified intraoperatively by an inadequate IOPTH decrease, whereas IOPTH decreased
inaccurately in the other 2 patients. In addition, in 1 of these 3 patients no abnormal
gland was found during minimally invasive parathyroidectomy and subsequent conventional
neck exploration. Therefore, only 2 reoperations would have been prevented (1.7%).
Conclusions
IOPTH would have changed the outcome in 2 patients, increasing the biochemical cure
rate from 96% to 98%. We believe that although it can be helpful in certain cases,
it may not be necessary routinely in patients treated for pHPT.
Keywords
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Article info
Publication history
Published online: December 23, 2011
Received in revised form:
July 21,
2011
Received:
January 15,
2011
Footnotes
The authors have no potential conflicts of interest.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
