Intraoperative parathyroid hormone monitoring.
The principles of minimally invasive parathyroidectomy include the successful preoperative localization of a solitary adenoma, a targeted operative approach that does not disturb the normal parathyroid glands, and intraoperative confirmation of excision of all hypersecreting parathyroid tissue. By providing real-time feedback to the surgical team, the rapid PTH assay allows surgeons to assess the completeness of parathyroid resection without visualizing all the parathyroid glands. Intraoperative PTH monitoring facilitates the use of local anesthesia, decreases the duration of surgery, and allows ambulatory surgery in most patients. This article reviews current recommendations and controversies surrounding the use of intraoperative PTH monitoring during parathyroidectomy.
Inabnet
William B
WB
Department of Surgery, Section of Endocrine Surgery, College of Physicians and Surgeons of Columbia University, New York Presbyterian Hospital, 161 Fort Washington Avenue, Room 820, New York, NY 10032, USA.
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000601:surgery*; D015592:Immunoradiometric Assay; D008163:Luminescent Measurements; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods; D011863:Radioimmunoassay
D010281:Parathyroid Hormone