[Value of the intraoperative determination of parathyroid hormone (PTH) in hyperparathyroidism surgery].
BACKGROUND
The success in the surgical management of hyperparathyroidism has conventionally required a bilateral neck exploration. The intraoperative monitoring of intact parathyroid hormone (PTHi), allows a less extensive procedure by confirming the complete removal of hypersecreting tissue.


METHODS
Plasma samples were obtained from 32 consecutive patients before and 10 minutes after removal of abnormal parathyroid tissue. PTH was measured with a modifie immunochemiluminometric assay with a short incubation time and the results made available in 15 minutes.


RESULTS
PTHi decreased by at least 60% in 30 of 32 cases. A single adenoma was removed in 26 cases, and multiple hyperplastic glands in 4 cases. The two cases in which PTHi fell < 60% were diagnosed as hyperplasia. PTHi decreased > 60% after the removal of the remnant hyperplastic glands.


CONCLUSIONS
The rapid PTHi assay had excellent analytical performance and predicted the success of parathyroid surgery.
Ferrer Ramírez
M J
MJ
Servicio de Otorrinolaringología, Hospital Universitario Dr. Peset, Valencia. mferrero@seorl.org
López Gutierrez
A
A
Oliver Oliver
M J
MJ
Canós Llacer
I
I
López Martínez
R
R
D000236:Adenoma / Q000378:metabolism / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000378:metabolism* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000378:metabolism*; D010282:Parathyroid Neoplasms / Q000378:metabolism / Q000601:surgery; D011300:Preoperative Care; D011446:Prospective Studies
D010281:Parathyroid Hormone