title: Arterial and venous parathyroid hormone levels in minimally invasive surgery.
abstract: OBJECTIVE
  To establish if venous and arterial parathyroid hormone (PTH) levels are similar during minimal access parathyroid surgery.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Marshfield Clinic, a large multispecialty tertiary care referral center in central Wisconsin.
  
  
  METHODS
  All patients who underwent minimally invasive parathyroid surgery over a 10-month period.
  
  
  RESULTS
  Fifteen consecutive patients were evaluated. There were 11 women and 4 men, with an average age of 65 years. All patients underwent a preoperative technetium Tc 99m sestamibi scan, with 11 localizing to the site of a probable adenoma. Mean ionized calcium levels were 5.95 mg/dL (1.49 mmol/L) preoperatively and 4.84 mg/dL (1.21 mmol/L) postoperatively. Of 13 patients undergoing both arterial and venous sampling, mean baseline venous PTH level was 221 pg/mL and 37 pg/mL at 10 minutes after excision of suspected adenoma (83% decline). Mean baseline arterial PTH level was 247 pg/mL and 38 pg/mL at 10 minutes after excision (84% decline). Using the Wilcoxon signed rank test, there was no significant difference in the arterial vs venous levels at baseline (P = .70) or 10 minutes (P = .48).
  
  
  CONCLUSIONS
  Intraoperative PTH levels during minimal access parathyroid surgery are similar for venous and arterial samples. Blood samples for PTH level monitoring can be obtained using a temporary indwelling arterial line.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marshfield Clinic, Marshfield, WI 54449, USA. urquhart.andrew@marshfieldclinic.org
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Urquhart
authors.forename: Carmen
authors.initials: C
authors.lastname: Wiley
mesh_terms: D000368:Aged; D001158:Arteries; D001800:Blood Specimen Collection / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D014680:Veins
chemical_list: D010281:Parathyroid Hormone