title: Central venous parathyroid hormone monitoring using a novel, specific anatomic method accurately predicts cure during minimally invasive parathyroidectomy.
abstract: BACKGROUND
  Measurement of intraoperative parathyroid hormone (PTH) levels is an important adjunct to confirm biochemical cure during parathyroidectomy. The purpose of this study was to evaluate a simplified anatomic technique for PTH sampling from the central veins through the minimally invasive neck incision, and to compare the predictive accuracy of central and peripheral PTH values.
  
  
  METHODS
  A specific anatomic method for central PTH sampling was employed in 48 patients. Samples were drawn simultaneously from peripheral and central veins at baseline and 10 minutes postexcision of all hyperfunctioning parathyroid glands.
  
  
  RESULTS
  The central venous PTH levels independently predicted biochemical cure according to the Miami criterion in all the patients. There was no significant difference in the postexcision central and peripheral values, which were 24.40 + 1.86 and 21.69 + 1.74, respectively (P = .877, ANOVA test).
  
  
  CONCLUSIONS
  This study provides the original description of a simplified technique for measurement of intraoperative PTH levels in the central veins with direct comparison to peripheral venous levels, and confirmation of accuracy in predicting biochemical cure when relying on centrally obtained values alone.
authors: Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA.
authors: Courtney M
authors: CM
authors: Edwards
authors: St. Peter's Health Partners Medical Associates, Albany, NY, USA.
authors: Jessica
authors: J
authors: Folek
authors: Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA.
authors: Samantha
authors: S
authors: Dayawansa
authors: Department of Surgery, Baylor Scott and White Hillcrest Medical Center, Waco, TX, USA.
authors: Cara M
authors: CM
authors: Govednik
authors: Yale Endocrine Surgery, Yale School of Medicine, New Haven, CT, USA.
authors: Courtney E
authors: CE
authors: Quinn
authors: The Ohio State University, OSU Hospitals East, Wexner Medical Center, Columbus, OH, USA.
authors: Benjamin R
authors: BR
authors: Sigmond
authors: Department of Surgery, University of Kentucky Health Care, Lexington, KY, USA.
authors: Cortney Y
authors: CY
authors: Lee
authors: Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA.
authors: Melissa S
authors: MS
authors: Angel
authors: Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA.
authors: John C
authors: JC
authors: Hendricks
authors: Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA. Electronic address: Terry.Lairmore@BSWHealth.org.
authors: Terry C
authors: TC
authors: Lairmore
mesh_terms: D000328:Adult; D001800:Blood Specimen Collection / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014680:Veins
chemical_list: D010281:Parathyroid Hormone
keywords: Intraoperative PTH; Minimally invasive surgery; Parathyroidectomy