[Surgical treatment of primary hyperparathyroidism with intraoperative iPTH determination].
BACKGROUND
Primary hyperparathyroidism (pHPT) is most frequently caused by a solitary adenoma. Surgical intervention has a high cure rate, particularly when associated with a fast intraoperative intact parathyroid hormone (IOPTH) assay.


OBJECTIVE
to evaluate the performance and accuracy when applying this technique.


METHODS
we conducted a retrospective study of the last 20 patients with pHPT (mean age 59, range 24-75) that had a surgical intervention in our unit. IOPTH was used in 14 patients, with dosage at 5, 10, 15 and 30 minutes after removal of the adenoma.


RESULTS
The localization exams had a sensitivity of >75%. The surgical procedure of choice was a unilateral dissection through a 4cm central mini-incision, with all patients experiencing a reduction of >50% of the IOPTH at 10 minutes. There were no surgical complications and the average length of the follow-up period was 11.4 months. The mean calcemia and iPTH dosage progression, from pre-surgery to the last follow-up visit, was respectively of 11 (SD1) to 9.4 (SD0.5) mg/dl and of 233.3 (SD177.5) to 57.1 (SD42) pg/ml. Symptoms improved in all patients.
Allen
Miguel
M
Serviço de Cirurgia II, Hospital de Egas Moniz, Lisboa.
Almeida
Isabel
I
Torrinha
Joaquim
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D012189:Retrospective Studies
D010281:Parathyroid Hormone