title: Role of parathyroid hormone monitoring during parathyroidectomy.
abstract: BACKGROUND
  The value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy has been previously debated.
  
  
  METHODS
  This retrospective analysis was of 240 patients, operated on for primary hyperparathyroidism (PHPT) between January 2002 and January 2006 and categorized into 3 groups by preoperative and intraoperative modalities: group 1 (n = 109), technetium 99m sestamibi (MIBI), ultrasonography, and IOPTH; group 2 (n = 102), ultrasonography and MIBI; and group 3 (n = 29), ultrasonography and IOPTH. Sensitivity and specificity were calculated.
  
  
  RESULTS
  In group 1, IOPTH increased the success rate from 97% to 99%. In group 2, ultrasonography and MIBI were concordant in 95% of cases. In group 3, IOPTH increased the sensitivity from 89% to 96%. The duration of surgery was longer (p < .0001) when IOPTH was applied.
  
  
  CONCLUSIONS
  When ultrasonography and MIBI are used, the additional benefit of IOPTH is marginal, especially given the longer duration of surgery. Ultrasonography and additional IOPTH yield good success rates when MIBI is not available.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gideon
authors.initials: G
authors.lastname: Bachar
authors.forename: Aviram
authors.initials: A
authors.lastname: Mizrachi
authors.forename: Tuvia
authors.initials: T
authors.lastname: Hadar
authors.forename: Raphael
authors.initials: R
authors.lastname: Feinmesser
authors.forename: Thomas
authors.initials: T
authors.lastname: Shpitzer
mesh_terms: D000236:Adenoma / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy
chemical_list: D010281:Parathyroid Hormone