title: [Usefulness of intraoperative parathormone measurement to predict surgical cure in primary hyperparathyroidism].
abstract: BACKGROUND
  The aim of the surgical treatment of primary hyperparathyroidism (PHPT) is to achieve its complete cure, evidenced by normal serum calcium in the postoperative period. Measurement of intraoperative serum parathormone (PTH) can be useful to predict complete cure of the disease.
  
  
  OBJECTIVE
  To assess the usefulness of intraoperative PTH measurement to predict complete cure of PHPT.
  
  
  METHODS
  Serum PTH was measured to all patients operated for PHPT between 2003 and 2008, before and five and ten minutes after the excision of the parathyroid gland causing the disease. The criteria for complete cure were normal serum calcium at 24 hours and 6 months after surgery and the pathological confirmation of parathyroid gland excision.
  
  
  RESULTS
  Eighty-eight operated patients, aged 58+/-15 years (72 females) were studied. Sixty four percent were asymptomatic and their preoperative serum calcium was 11.6+/- 1.2 mg/dl. A normal serum calcium was achieved in 86 patients (98%) at 24 hours and 50 of 52 patients followed for six months (96%). The pathological study disclosed an adenoma in 69 (78%), and multiglandular disease in 16 (18%), a parathyroid cancer in one and a normal gland in one patient. Intraoperative PTH predicted early and definitive cure in 97% and 100% of patients with a single adenoma, respectively. Among patients with multiglandular disease, the predictive figures were 94% and 100%, respectively.
  
  
  CONCLUSIONS
  Intraoperative PTH measurement efficiently predicts early and definitive surgical cure of PHPT.
authors.affiliation: Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Domínguez
authors.forename: Soledad
authors.initials: S
authors.lastname: Velasco
authors.forename: Ignacio
authors.initials: I
authors.lastname: Goñi
authors.forename: Augusto
authors.initials: A
authors.lastname: León
authors.forename: Hernán
authors.initials: H
authors.lastname: González
authors.forename: Raúl
authors.initials: R
authors.lastname: Claure
authors.forename: Eugenio
authors.initials: E
authors.lastname: Arteaga
authors.forename: Claudia
authors.initials: C
authors.lastname: Campusano
authors.forename: Carlos
authors.initials: C
authors.lastname: Fardella
authors.forename: José Manuel
authors.initials: JM
authors.lastname: López
authors.forename: Lorena
authors.initials: L
authors.lastname: Mosso
authors.forename: José Adolfo
authors.initials: JA
authors.lastname: Rodríguez
authors.forename: Gilberto
authors.initials: G
authors.lastname: González
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000209:etiology / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000601:surgery*; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D002118:Calcium