Quick parathormone assay in the surgical management of hyperparathyroidism.
BACKGROUND
Among the various new technologies in the field of parathyroid surgery is intraoperative quick parathormone measurements.


OBJECTIVE
To evaluate the contribution of QPTH measurements during parathyroidectomy to the achievement of higher success rates.


METHODS
QPTH assay using Immulite Turbo Intact PTH was measured in 32 patients undergoing parathyroidectomy: 30 for primary and 2 for secondary hyperparathyroidism. QPTH levels were measured at time 0 minutes (before incision) and at 10, 20, and 30 minutes after excision of the hyperfunctioning gland. Only a drop of 60% or more from the 0' level was considered to be a positive result.


RESULTS
The mean QPTH level at time 0' for PHPT patients was 38.12 +/- 25.15 pmol/L (range 9.1-118 pmol/L). At 10 minutes post-excision of the hyperfunctioning gland (or glands), QPTH dropped by a mean of 73.80% to 9.89 +/- 18.78 pmol/L.


CONCLUSIONS
Intraoperative QPTH level measurement is helpful in parathyroid surgery. A drop of 60% or more from 0' level indicates a successful procedure, and further exploration should be avoided.
Halevy
Ariel
A
Surgical Division, Assaf Harofeh Medical Center, Zerifin, Israel. ahalevi@asaf.health.gov.il
Stepansky
Albert
A
Halpern
Zvi
Z
Wassermann
Ilan
I
Chen-Levy
Zehava
Z
Pytlovich
Shlomo
S
Marcus
Ora
O
Mor
Anat
A
Hagag
Philip
P
Horne
Tifha
T
Polypodi
Semione
S
Sandbank
Judith
J
D000236:Adenoma / Q000150:complications / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002828:Choristoma / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006965:Hyperplasia / Q000150:complications / Q000473:pathology; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000473:pathology; D011300:Preoperative Care / Q000379:methods; D013965:Thyroidectomy; D016896:Treatment Outcome; D014463:Ultrasonography
D010281:Parathyroid Hormone