title: Intraoperative parathyroid hormone monitoring to determine long-term success of total parathyroidectomy for secondary hyperparathyroidism.
abstract: BACKGROUND
  Use of intraoperative parathyroid hormone (ioPTH) monitoring during total parathyroidectomy for secondary hyperparathyroidism is common, although its ability to predict long-term normoparathyroid state is not known.
  
  
  METHODS
  Prospective evaluation of 57 consecutive patients undergoing total parathyroidectomy for renal hyperparathyroidism with ioPTH monitoring and follow-up PTH assays were used to categorize the patients into 3 groups: success, adequate biochemical control, and failure.
  
  
  RESULTS
  There was no statistically significant difference in percentage reduction of ioPTH between the 3 groups (p = .07), although there was a moderate negative correlation between percentage reduction of ioPTH and percentage reduction of PTH at follow-up (R = 0.57).
  
  
  CONCLUSIONS
  When used under current guidelines, ioPTH monitoring is of no use in predicting long-term cure for these patients because it does not predict success. Patients that undergo total parathyroidectomy are required to have long-term calcium and PTH assay follow-up because normoparathyroidism cannot be assumed. Using the regression equation calculated, success may be predicted for future patients.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hull Royal Infirmary, Hull, UK.
authors.forename: James W
authors.initials: JW
authors.lastname: Moor
authors.forename: Steven
authors.initials: S
authors.lastname: Roberts
authors.forename: Steven L
authors.initials: SL
authors.lastname: Atkin
authors.forename: R James A
authors.initials: RJ
authors.lastname: England
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy / Q000009:adverse effects* / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone