title: Can the use of intraoperative intact parathyroid hormone monitoring be abandoned in patients with hyperparathyroidism?
abstract: BACKGROUND
  Ultrasound (US) and technetium-99m sestamibi scintigraphy (MIBI) are used to determine the localization of abnormal glands in cases of primary hyperparathyroidism (PHPT). Intraoperative intact parathyroid hormone (iPTH) monitoring is a reliable examination used to cure PHPT. The aim was to assess the necessity of intraoperative iPTH monitoring.
  
  
  METHODS
  Sixty patients were examined using preoperative MIBI and US. iPTH was measured at 3 time points: (1) at the start of surgery; (2) 10 minutes after gland resection; and (3) more than 60 minutes after surgery. We defined a decreased iPTH level as an iPTH measured 10 minutes after resection that was less than 50% of the preoperative level.
  
  
  RESULTS
  The iPTH of 55 patients with concordant lesions decreased to within the normal range more than 60 minutes after surgery.
  
  
  CONCLUSIONS
  It is not necessary to monitor intraoperative iPTH when single concordant lesions are preoperatively identified on both MIBI and US.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Sakimura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Minami
authors.forename: Naomi
authors.initials: N
authors.lastname: Hayashida
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Uga
authors.forename: Naoko
authors.initials: N
authors.lastname: Inokuchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
mesh_terms: D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D011300:Preoperative Care; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography
chemical_list: D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
keywords: Intraoperative intact parathyroid hormone monitoring; Primary hyperparathyroidism; Technetium-99m sestamibi scintigraphy; Ultrasound